Beach Retreat 2K17: The Lakening SIGN UP
Name
ncsu email
phone number
What is the earliest you can leave on Friday? (ie. be AT the Health Center ready to leave)
Are you part of a Small Group with IV?
Can you drive a car, and if so, how many people can you take?
In consideration for being accepted and allowed to participate in this conference/project and activities associated with its program and location, I personally assume responsibility for my actions, and release InterVarsity Christian Fellowship/USA® (hereafter InterVarsity®), its Trustees, employees and agents from loss, injury or damage to myself or my property; provided that nothing contained herein shall excuse InterVarsity, its Trustees, employees or agents from responsibility to act with reasonable care for the safety of myself or my property. 2. I give permission to InterVarsity to be photographed, recorded, and/orvideo taped and to allow this material to be used for publicity. 3. I give permission to InterVarsity to obtain medical assistance in the event of an emergency. This permission will include the administration of medicines, surgical treatment, X-ray examination or hospitalization as might be ordered by a licensed medical doctor. I release and discharge InterVarsity, its trustees, employees, and agents from any liability for anyfirst aid rendered or treatment performed pursuant to this consent. 4. I understand that InterVarsity has a hostage policy that states that InterVarsity should not yield to demands, including the payment of ransom or other extortion, issued through the use of hostage taking or extortion. 5. If I am under age 18 (if you are, please check here G), I state that Iam a mature minor (of college age and living away from parent/guardian) and have the capacity to consent to the terms of this Release. 6. Any claim or dispute arising from or related to this release shall be settled by mediation and, if necessary, legally binding arbitration in accordance with the Rules of Procedure for Christian Conciliation of the Institute for Christian Conciliation, a division of Peacemaker® Ministries (complete text of the Rules is available at www.HisPeace.org). Judgment upon an arbitration decision may be entered in any court otherwise having jurisdiction. I understand that these methods shall be the sole remedy for ny controversy or claim arising out of this release and expressly waive my right to file a lawsuit in any civil court against InterVarsity for suchdisputes, except to enforce an arbitration decision. I certify that I am competent to sign this Release, and have done so voluntarily. DO YOU AGREE?
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