Scouts Canada - Physical Fitness Certificate Template Page 3

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SCOUTS CANADA
INDIVIDUAL RELEASE AND HOLD-HARMLESS AGREEMENT
Dorchester International Cuboree Camp
I understand that participation in the
which is sponsored
(Describe Activity)
Sept 27-29, 2013
1st Dorchester
by the
, Scouts Canada and is to be held on
,
(Name of Council, Area, Group)
(Date)
involves a certain degree of risk that could result in injury, death or loss or damage to person or
property. After carefully considering the risk involved, and in view of the fact that Scouts Canada is
a not-for-profit organization, I hereby release, hold-harmless and waive all claims associated with
this activity which I may have against Scouts Canada, its employees, officers, directors, agents,
volunteers and members.
Name of Participant (please print):
Signature (if 18 or over):
Date:
If participant is under 18 years of age, this release must be signed by a parent or guardian.
Name of Parent/Guardian (please print):
Parent/Guardian:
Date:
Note: Please forward completed copies of this form to your Council Offices.
B.P.&P., Section 20000
February 2007

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