Release of Liability, Assumption of Risk, and Indemnification Agreement
This document affects your legal rights: Read carefully before signing.
The undersigned is the participant or the legal guardian of a minor child who desires to engage in certain activities at Lake Retreat Camp and Conference Center (“LRCC”). On behalf of myself (“Participant” or “Guardian”), and my minor child (“Camper”), I hereby waive the rights described below and release LRCC from liability related to the activities described herein.
- ACTIVITY AND ASSOCIATED RISKS: I have chosen to participate or allow my Camper to participate in activities at Lake Retreat Camp including but not limited to paintball and archery tag, (the “Activities”), which is provided by Lake Retreat Camp and Conference Center (“LRCC”). I understand, acknowledge and agree that:
- These Activities are inherently dangerous and hazardous, and that I or my Camper may be exposed to dangers, hazards, and physical and mental trauma.
- As a consequence of these risks, I or my Camper may be seriously hurt, disabled, or may die from the resulting injuries, and my property may also be damaged.
- Hospital facilities, qualified medical care, and medical evacuation may be limited by local conditions; and
- LRCC assumes no responsibility for providing medical care during the Activities, and I shall be solely responsible to pay for any medical care and/or evacuation that myself or my Camper incurs.
- ASSUMPTION OF THE RISKS: I agree that my participation or my Camper’s participation in the Activities are entirely voluntary and I, or I on my Camper’s behalf, freely assume the above-mentioned risks and any harm, injury or loss that may occur as a result of my or my Camper’s participation in the Activities.
- RELEASE OF LIABILITY: I, or I on behalf of Camper, hereby waives any claims against and releases LRCC, its agents, employees, contractors and suppliers from, any liabilities, claims, causes of action, or expenses (including attorney fees) that arise from or are related in any way to injuries or damages, of any kind or any nature, resulting from the Activities.
- INDEMNIFICATION. I agree that I shall indemnify and hold harmless LRCC from and against any and all claims, causes of action, expenses (including attorney fees and costs), liabilities and/or obligations that arise out of or are related in any way to my or my Camper’s participation in the Activities.
- AUTHORITY. Guardian represents and warrants that Guardian has the legal authority to execute this document and to act on behalf of Camper.
I, or Guardian on behalf of Camper, hereby grant to LRCC, its representatives, and employees the right to take photographs/videos of myself or my Camper in connection with my or my Camper’s participation at LRCC. I hereby authorizes LRCC to copyright, use, and publish the same in print and/or electronically. I hereby agree that LRCC may use such photographs of myself or my Camper for any lawful purpose, including but not limited to publicity, illustration, advertising, and Web content.
Check Applicable Activities:
___ Archery Tag ______(Initial) ___Paintball ______ (Initial)
Participant’s Signature Date
For Minor’s Participation:
Parent/Guardian Signature Date Print Participant’s Name
Parent/Guardian Printed Name Participant’s Date of Birth
Relationship to Participant Camp/Group/Church Name