SO YOU RE GOING TO CAMP LIVING STONES HERE S WHAT YOU NEED TO KNOW!

Transcription

1 SO YOU RE GOING TO CAMP LIVING STONES HERE S WHAT YOU NEED TO KNOW! NEED TO BRING: Bible, journal, and writing apparatus 2 towels and toiletries Sleeping gear (pillow, sleeping bag or blanket and sheets for a twin size bunk bed) Sunscreen Rain Jacket Insect Repellant Clothes (work worthy shoes, secure sandals or shoes for rafting, work clothes, one- piece swimsuit, shorts, t- shirts for everyday wear ) Great attitudes! NEED TO LEAVE: Expensive Jewelry Electronics (ipods, TVs, radios, gaming systems, etc.) Any kind of illegal drugs (chews, chaws, puffs, sniffs, tokes, or alcoholic dranks!) Fireworks Prank stuff Bad attitudes If in doubt, leave it out! CLS DRESS CODE: Guys Please keep your shirts on at camp and at mission sites at all times. Make sure to wear closed- toe shoes for activities at camp. Girls Bring longer shorts for activities and avoid shirts that are low cut or midriff- baring. Sleeveless shirts need to have straps as wide as three fingers. Modest one- piece swimsuits are required for water activities; a two- piece swimsuit may be worn with a dark T- shirt over it. CAMP STORE: Be sure to bring extra cash (or checks) to pick up some snacks and souvenirs at our camp store! No items are over $25. We sell: Short Sleeve T- shirts Long Sleeve T- shirts Hoodies Crewneck Sweatshirts Water Bottles Bandanas Hats Decals Blankets Pens Backpacks Cookbooks Photo prints Disc Golf discs Drawstring Bags Jewelry Sunglasses Books Magnets DRINKS & SNACKS!!

2 Waiver, Release, and Hold Harmless Agreement I know that participating in Camp Living Stones adventure program can be potentially hazardous in nature. I assume all risks associated with participating in the adventure activities, including, but not limited to, broken bones, paralysis, and death all risks being known and assumed by me. Having read this waiver and release and knowing these facts and in consideration of my participation in the adventure activities, I for myself, and anyone entitled to act on my behalf, waive and release Camp Living Stones, Inc., their Board of Directors, officers, and successors from all claims and liabilities arising out of my participation in the adventure activities. I furthermore agree to hold the foregoing parties harmless from any injury that might result from my participation. I grant my permission to the foregoing parties to use any photographs, motion pictures, recordings, or any other record of this event for any legitimate purpose. Camp s Phone Number Participant with: (Church/Organization attending) Home Address Participant s Name (Print) Participant s signature Parent/Guardian signature (in addition to child s signature) PLEASE FILL OUT COMPLETELY

3 Medical Information Name Last First Participant with: (Church/Organization attending) Birthdate Sex Age Parents/Guardian Address City State Zip Emergency No./Work Phone / Physician s Name Phone ( ) Health Insurance Co. & Address Policy No. Health Problems/Special Needs Drug/Food Allergies Polio Vaccine Current Y / N Last Tetanus Shot Regular Medication Activity Restriction PARENTS: Please read, sign, and date the following: Our insurance coverage is a secondary carrier. Our campers insurance begins where yours terminates. It is only valid when your policy has been extended to its limits. In the event that you have no personal or organizational policy, our policy will provide you with complete coverage within its limits subject to policy provisions. Please provide us with the name of your health insurance carrier and your policy number in the event of a hospital visit. IN CASE OF A MEDICAL EMERGENCY, I hereby give permission to the physician selected by the Camp Director to hospitalize, secure proper treatment for, and to order injection, anesthesia, or surgery for my child, as named above. Signature Important: Please notify the camp if child has a communicable disease. If applicable, please photocopy insurance card and submit with this sheet.

4 Final Counts Please return or e- mail information to Name M/F Age Grade Completed

5 Living the Mission Community Service Projects (please fill out appropriate waiver below) Parental Consent and Release of Liability Waiver for Adults Only Waiver for Minors Only In consideration of our child,, being allowed to participate in the Volunteer Program by the city (or town) of Etowah, TN, we acknowledge that working on municipal projects can be a hazardous activity. Nevertheless, we grant permission for our child to participate in this activity and assume all the risks associated with this work. We waive all claims for damages against the city and against its officers and employees for injury to our child's person or property, including death and destruction, and resulting injuries and damages to us that may arise from this activity. We release the city and its officers and employees and agree to hold them harmless from any such liability. This agreement shall remain in force until we revoke it in writing. Signature of Parent or Guardian Release of Liability Volunteers aged must have parental consent. BOTH parents or guardians must sign this form. Signature of Parent or Guardian In consideration of being allowed to participate in the Volunteer Program by the city (or town) of Etowah, TN, I acknowledge that working on municipal projects can be a hazardous activity, and I assume all the risks associated with this work. I waive all claims for damages against the city and against its officers and employees for injury to my person or property, including death and destruction that may arise from this activity and I release the city and its officers and employees and agree to hold them harmless from any such liability. This agreement shall remain in force until I revoke it in writing. Signature of Participant DO NOT use this form for Minors. Parents or Guardians should be required to sign the Parental Consent and Release of Liability form. Volunteers aged must have parental consent.

6 Ocoee River Rafting Waiver OUTDOOR ADVENTURES OF TENNESSEE (O.A.R. ) Read Carefully: Waiver and Release of Liability In consideration of OUTDOOR ADVENTURES OF TENNESSEE furnishing services and/or equipment to enable me to participate in OUTDOOR ACTVITIES, I agree as follows: I fully understand and acknowledge that outdoor recreational activities have: (A) Inherent risks, dangers and hazards and such exists in my use of (Circle) RAFTING, RAPPELLING, CLIMBING, ROPES COURSE, TUBING, ALPINE TOWER, ADVENTURE RACES, PAINTBALL equipment and my participation in WHITEWATER RAFTING activities; (B) My participation in such activities and/or use of such equipment may result in injury or illness including, but not limited to, bodily injury, disease, strains, fractures, partial and/or total paralysis, death or other ailments that could cause serious disability; (C) These risks and dangers may be caused by the negligence of the owners, employees, officers or agents of, but not limited to, OUTDOOR ADVENTURES OF TENNESSEE, the State of Tennessee, Ocoee River Outfitters Association, the Tennessee Valley Authority, the negligence of the participants, the negligence of others, accidents, breaches of contract, the forces of nature or other causes. Risks and dangers may arise from foreseeable or unforeseeable causes including, but not limited to, guide decision making, including that a guide may misjudge terrain, weather, trail or river route location, and water levels, risks or falling out or of drowning while in a raft, tube and such other risks, hazards and dangers that are integral to recreational activities that take place in a wilderness, outdoor or recreational environment; and (D) By my participation in these activities and for use of equipment, I hereby assume all risks and dangers and all responsibility for any losses and/or damages, whether caused in whole or in part by the negligence or other conduct of the owners, agents, officers, or employees of OUTDOOR ADVENTURES OF TENNESSEE, or by any other person. I, on behalf of myself, my personal representatives and my heirs hereby voluntarily agree to release, waive, discharge, hold harmless, defend and indemnify OUTDOOR ADVENTURES OF TENNESSEE, the State of Tennessee, Ocoee River Outfitters Association the Tennessee Valley Authority and their owners, agents, the United States of America, officers and employees representative and lenders from any and all claims, actions or losses for bodily injury, property damage, wrongful death, loss of services or otherwise which may arise out of my use of rafting equipment or my participation in WHITEWATER RAFTING, RAPPELLING, CLIMBING, ROPES COURSE, TUBING, ALPINE TOWER or ADVENTURE RACE, PAINTBALL activities. I specifically understand that I am releasing, discharging, and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by the owners, agents, officers or employees or representative of OUTDOOR ADVENTURES OF TENNESSEE the State of Tennessee, Ocoee River Outfitters Association, the Tennessee Valley the United States of America. I HAVE READ THE ABOVE WAIVER AND RELEASE AND BY SIGNING IT AGREE. IT IS MY INTENTION TO EXEMPT AND RELIEVE OUTDOOR ADVENTURES OF TENNESSEE the State of Tennessee, Ocoee River Outfitters Association, the Tennessee Valley Authority and the United States of America FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE. (E) I understand that I may be photographed or videoed while participating in activities and give my permission for these photos and/or videos to be used for marketing and promotional purposes. NAME OF PARTICIPANT DATE OF BIRTH DATE OF ACTIVITIES / / from to SIGNATURE SIGNATURE OF PARENT OR GUARDIAN (if less than 18 years old ) Sign here Print here E- mail Address ADDRESS OF PARTICIPANT (Please Print) Name Street City/State/Zip

7 River Outing Waiver WILD RIVER RETREAT Parental Consent and Release of Liability (for participants under age 18) I understand that in consideration for my child,, to attend an outing at Wild River Retreat with Camp Living Stones, I do hereby waive, release, and forever discharge any and all rights to claims against Wild River Retreat, its benefactors, or directors for any damages or injuries sustained by my child while attending this outing. I understand that my child is to use the facility in the way it is intended, observe Tabernacle Time, treat others with respect, and obey any and all safety guidelines. I am aware that Wild River Retreat DOES NOT provide a lifeguard. I also state that, to the best of my knowledge, my child is fit and able to participate in all activities at Wild River Retreat. I understand that Wild River Retreat does not carry health/accident insurance. I state, as the guardian, my child is covered by the insurance policy listed below. I authorize, in case of emergency, the group chaperone or leader in charge to act on my behalf according to their best judgment. Signature of Parent/Guardian of Parent/Guardian Contact Phone Number Additional Emergency Phone Number Insurance Company Subscriber s Name Policy # Please list any allergies or conditions Wild River Retreat needs to be aware of: Waiver and Release (for participants age 18 or older) In consideration for my participation at Wild River Retreat with Camp Living Stones, I do hereby waive, release, and forever discharge any and all rights and claims against Wild River Retreat, its benefactors, or directors for all damages sustained by me or my child while attending an outing at Wild River Retreat. I understand that I am to use the facility in the way it is intended, observing Tabernacle Time, treating others with respect and obeying any and all safety guidelines. I also understand that Wild River Retreat provides neither a lifeguard nor health/accident insurance. My signature below indicates that I have read and understood the above statements. Signature Address Contact Phone Number