Work Camp Waiver And Release Of Liability Form printable pdf download

Work Camp Waiver and Release of Liability Form

In consideration for being allowed to participate in any way in a work camp and/or related activities sponsored by The

Division for Outdoor Ministries, United Church of Christ, the undersigned:

1. Acknowledges and understands that he/she will be engaging in activities that involve risk of serious injury,

including disability and death, severe social and economic losses. These consequences might result not only

from his/her own action, inaction or negligence, but also from the actions, inaction or negligence of others

during the course of the activities referred to above. Further, the undersigned acknowledges and fully

understands that there may be other risks not known or reasonably foreseeable at this time.

2. Assumes all of the foregoing risk and accepts personal responsibility for any damages following such an injury,

permanent disability, and death or property damage.

3. Agrees to release, waive and discharge any liability by The Division for Outdoor Ministries, United Church of

Christ, their staff, associates, volunteers, their respective heirs, legal representatives, successors, and assigns for

any causes of action, claims, demands, damages or expenses on account of or in any way growing out of any and

all personal injuries, permanent disability, death , and/or property damage resulting or to result from any

activities related to the above-described work camp.

4. States that he/she has carefully read the foregoing release, understands its implications, and signs it as his/her

own free act.

Photographs, Video

I D o or

Do Not

(circle one)

allow photographs and/or video representations of me or my child to be taken for the express purpose of telling stories about

the work camp experience and promoting camping experiences in the future.

Signature

D ate

I HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT,

AND SIGN IT VOLUNTARILY.

______________________________________

________________________________________

Printed Name of Participant

Signature of Participant

Date:___________________________________

For Minors under 18 years:

_____________________________________

________________________________________

Printed Name of Parent (s)

Signature of Parent (s)

Date:___________________________________

In case of an emergency please supply a contact name and phone numbe

Name_____________________________________________ phone number_____________________

Work Camp Waiver And Release Of Liability Form