Participant Release of
Liability and Media Usage Authorization
This agreement (“Agreement”) is hereby
made between Faulkner Baptist Association , an Arkansas Non-profit Corporation
d/b/a Cold Springs Retreat (“the Camp”) and person agreeing to this form (“Participant”)
In consideration of being allowed to participate in any
program, related events, and activities INCLUDING BUT NOT LIMITED TO HIGH
ROPES, LOW ROPES OR INITIATIVES, RECREATIONAL EQUIPMENT USAGE AND ANY BALLFIELD
ACTIVITES (“Programs”) at the Camp, I, the undersigned Participant, acknowledge
and agree that:
1.
The risk of injury from the activities involved in this program
is significant. While rules, equipment, and personal discipline may reduce this
risk, the risk of serious injury does exist;
2.
I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known
and unknown, including that which arises FROM THE NEGLIGENCE OF THE
Participant, the Camp, or others, and assume full responsibility for my
actions;
3.
I willingly agree to comply with the stated and customary
terms and conditions for participation. If, however, I observe any unusual
significant hazard during my presence or participation, I will remove myself
from participation and bring such to the attention of the nearest Camp official
immediately;
4.
I understand that photographs and video footage taken as a
result of participation in the event may be used in the Camp materials,
publications and/or posted to the Internet. By my signature below, I hereby
grant world-wide, perpetual license of my image or my minor child’s image and
agree to waive any right to inspect or to approve the materials that the Camp
may choose to publish in any manner;
5. In
addition to the extent this release is for myself, as an adult attending Camp,
I understand the responsibility I have to supervise, protect and safeguard the
children and youth with whom I am staying. I attest that I have not participated
in behavior of moral turpitude that may cause the Camp concern for my ability
to be a Christian role model and to safely supervise minors; and
6.
I understand the
Camp has put in place certain measures to reduce the spread of COVID-19;
however, the Camp cannot guarantee that I or my child(ren) will not
become infected with COVID-19 while attending the Camp. Further, I understand that attending the Camp
could increase my risk and my child(ren)’s risk of contracting
COVID-19. By signing this agreement, I
acknowledge the contagious nature of COVID-19 and voluntarily assume the risk
that my child(ren) and I may be exposed to or infected by COVID-19 by attending
the Camp and that such exposure or infection may result in personal injury,
illness, permanent disability, and death.
I understand that the risk of becoming exposed to or infected by
COVID-19 at the Camp may result from the actions, omissions, or negligence of
myself and others, including, but not limited to, Camp employees, volunteers,
participants and their families. I understand and agree that this release
includes any claims based on the actions, omissions, or negligence of the Camp,
or its employees, agents and representatives, whether a COVID-19 infection
occurs before, during, or after participation in any Camp event or program.
I, the Participant, for myself and on behalf of my heirs, assigns,
personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD
HARMLESS the Camp, their officers, officials, trustees, agents and employees,
the Faulkner Baptist Association and its officers and its agents, officers and
trustees, other participants, sponsoring agencies, sponsors, advertisers, and, if
applicable, owners and lessors of premises used to conduct the event WITH
RESPECT TO ANY AND ALL SICKNESS, INJURY, DISABILITY, DEATH or loss or damage to
person or property, WHETHER ARISING FROM THE NEGLIGENCE of the Camp or their
agents and employees or similar, to the fullest extent permitted by law; and I
HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY
UNDERSTAND ITS TERMS, AND UNDERSTAND that I, by freely and voluntarily signing
this Agreement, acknowledge the risk associated with participation.
For Parents/Guardians of
Participant of Minor Age
(Under age 18 at time of
registration)
This is to certify that I, the undersigned, as a parent/guardian
with legal responsibilities for the Participant, hereby do consent and agree to
his/her release as stated above, and, for myself, my heirs, assigns, and next
of kin, I agree to indemnify and hold harmless the Camp for all incidents
involving my minor child’s participation in the Programs to the fullest extent
permitted by law.
