Junior High Winter Retreat 2020
Register for Junior High Winter Retreat! January 24-26, 2020 at Diamond Arrow Christian Camp

COST: $150 if registered before 12/22, $170 after. $50 to save your spot! (Scholarships available - talk to Neil!)

LOGISTICS: We will be leaving from the Haffly's house (2737 Blackburn Dr) at 3:45 on Friday and returning around 3:30 on Sunday.

PACKING LIST:
Shoes/gloves/hats/clothes for the snow or rain
Warm clothes for 2 days and nights
Toiletries and towel
Flashlight
Sleeping bag and pillow
Snack for car ride on Friday night
Money for lunch on the way home
Bible, pen, and notebook or journal
You may bring phones, but please only use them for taking pictures. Embrace the gift of the retreat and focus on God and the people you are with! The adults on the trip will ask you not to be on social media, play games, etc.

Contact Neil if you have any questions: neil@fbcdavis.org / 530.761.3289
Email address *
Student name
Your answer
M/F
T-shirt size
Grade
Student cell phone
Your answer
Parent cell phone
Your answer
Address (Street, City, Zip)
Your answer
Health problems/allergies
Your answer
Dietary restrictions
Your answer
Activity restrictions
Your answer
Regular medications
Your answer
LH leaders may administer Tylenol or Ibuprofen to my child if needed
Insurance info (company, policy or group or ID #)
Your answer
Emergency contact - name
Your answer
Emergency contact - relationship
Your answer
Emergency contact - phone
Your answer
FBC Release
I give permission for my child to participate in the 2020 Winter Retreat, and I will not hold the First Baptist Church of Davis, its members, officers, youth leaders, or those providing transportation or entertainment liable in any way for injuries attained. I permit the event staff to secure any medical treatment deemed necessary by a qualified medical examiner in case of an injury.

I also agree to permit reasonable use of photos, videos, or other images of my children and family to promote community life at First Baptist Church. I give permission to First Baptist Church for photographs and video of my child to be published (e.g. slide shows, webpages, blogs, Facebook, Instagram, Vimeo, YouTube) or posted (e.g. on bulletin boards, brochures, church calendars) by First Baptist Church.
Diamond Arrow Christian Camp Waiver
Release executed on [Date filled out below], by [Participant Name or Guardian of Participant Name below] (the 'Releasor' – Participant or Guardian of Participant under the age of 18) to Diamond Arrow Christian Conference Center (the 'Releasee') of 15742 N Bloomfield Road, Nevada City, California.

I, the Releasor, being of lawful age, in consideration of being permitted to participate in the ropes course, swimming pool, archery, paintball, Archery Tag®, and/or any other activities, scheduled for 1/24/20 -1/26/20, and run and/or operated by the Releasee, WAIVE, RELEASE, and DISCHARGE the Releasee, its owners, officers, directors, employees, members, agents, assigns, legal representatives and successors, and all business associates and partners involved in the presentation of the above noted activity and each of them their owners, officers and employees, from all liability for or by reason of any damage, loss or injury to person and property, even injury resulting in the death of the Releasor, which has been or may be sustained in consequence of the Releasor's participation in the activity described above, and notwithstanding that such damage, loss or injury may have been caused solely or partly by the negligence of the Releasee.

I hereby acknowledge and agree that I have carefully read this Waiver and Release agreement, that I fully understand
same, and that I am freely and voluntarily executing same.

By signing this release I will be forever prevented from suing or otherwise claiming against the Releasee for any property
loss or personal injury that I may sustain while participating in or preparing for the above noted activity.

I have been given the opportunity and have been encouraged to seek independent legal advice prior to signing this Waiver and Release agreement.

I understand that I would not be permitted to participate in the above noted activity unless I signed this Waiver and
Release agreement.

I understand that this Waiver and Release agreement is binding on me, my spouse, my heirs, my executors, administrators, personal representatives and assigns.

I acknowledge that I do not have any physical limitations, medical ailments, physical or mental disabilities that would
limit or prevent me from participating in the above mentioned activity, and, if required, will obtain a medical examination
and clearance.

This release contains the entire agreement between the parties to this release and the terms of this release are contractual and not a mere recital. This Waiver and Release Agreement will be construed in accordance with and governed by the laws of the State of California, and it is acknowledged by the Releasor to be as broad and inclusive as permitted by the laws of this jurisdiction.

I HAVE READ AND UNDERSTAND THIS AGREEMENT, AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS MAY HAVE AGAINST THE RELEASEE(S).
Participant Name (electronic signature)
Your answer
Guardian of Participant Name (electronic signature)
Your answer
Date
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