*You and your mentor must register separately. Please be sure to list each other on the registration form below so we can work with you together.

*You and your mentor must register separately. Please be sure to list each other on the registration form below so we can work with you together.

ASSUMPTION OF RISK AND RELEASE OF LIABILITY

Read the following items pertaining to assumption of risk and liability release, in connection with the Men of Valor retreat.  If you choose to sign and initial this document, and acknowledge agreement of the terms therein, you will be permitted to participate in the weekend experience.  Those who do not sign this document will not be eligible to participate.

1. I voluntarily elect to participate in the “Men of Valor” weekend and in doing so I expressly agree, promise and do accept and assume ALL of the risks existing in THE EVENT and its individual activities and processes.
2. I certify that I voluntarily choose to participate in THE EVENT because I believe it may be helpful to my own personal growth and development.  I am not participating in THE EVENT because of pressure from anyone else.
3. I acknowledge that participation in personal growth and development courses and activities involves both known and unanticipated risks that could result in physical or emotional injury or damage to myself or others.
4. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of THE EVENT.  These risks include, among other things:  emotional stress or trauma; strenuous and vigorous physical, mental emotional and intellectual activity; the possibility of slips and falls; bruises, sprains, lacerations, fractures, animal bites or stings, concussions or even more severe life-threatening hazards, including death.  Furthermore, THE EVENT volunteers and staff have difficult jobs to perform.  They seek safety, but are not infallible.  They might be ignorant of a participant’s fitness or abilities.  They might misjudge the weather, the elements, or the terrain.  They may give inadequate warnings or instructions, and the equipment being used might malfunction.
5. My participation in THE EVENT is purely voluntary, and I elect to participate in THE EVENT in spite of the risks.  I recognize that I am free to elect to not participate in any given activity or process of THE EVENT for any reason.  I also am free to leave THE EVENT at any time for any reason.
6. I recognize that THE EVENT constitutes non-professional peer support and coaching.  I recognize that THE EVENT collectively and its individual activities do NOT constitute professional therapy or professional psychological counseling, and that THE EVENT instructors are not professional therapists/counselors and/or are not working in the capacity of professional therapists/counselors in the course of THE EVENT.
7. I understand that opportunities may be provided at certain times in the course of THE EVENT to receive physical support (eg., hand on the shoulder, offering stability, bracing for balance, high-fives or hugs).  I recognize that I am free to elect to not receive or accept such support, and I take full responsibility for communicating and maintaining my personal physical boundaries. If I refuse support needed due to safety concerns, I will be asked to step away from the activity for my protection. 
8. I will not engage in any sexual activity, pornography, erotic touch or romantic flirtations of any kind during the time that I am at THE EVENT.  I also promise that I will not approach ANYONE I may meet at THE EVENT for sexual or romantic activity of any kind either during the weekend or at any time following the weekend.
9. I understand that I am NOT permitted to maintain correspondence or communication with any youth participants or youth staff, following this weekend.
10. I recognize that I alone, am responsible for the quality of experience I have at THE EVENT and for its efficacy in affecting change and development in my life.
11. I hereby voluntarily release, forever discharge and agree to indemnify and hold harmless “Men of Valor,” volunteers, staff and committee members of THE EVENT, individually and collectively, and their families, employers, associates and affiliated organizations, from any and all claims, demands, or causes of action, which are in any way connected with my participation in, transportation to or from, or presence at THE EVENT, or use of its equipment or facilities, including any such claims that allege negligent acts or omissions on the part of anyone involved in THE EVENT.  I hereby voluntarily agree to this release on behalf of myself, my children, my parents, my heirs, assigns, personal representatives and estate.
12. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating in or present at THE EVENT, or else I agree to bear the costs of such injury or damage to myself.  I further certify that I have no medical or physical conditions which could interfere with my safety at THE EVENT, or else I am willing to assume and bear the costs of all risks that may be created, directly or indirectly, by any such condition.  I have sought the advice of a physician and believe I am in good health.
    By signing this document, I acknowledge that if anyone is hurt, or property is damaged during THE EVENT, or if I feel I have suffered psychological or emotional harm or otherwise am in any way dissatisfied with THE EVENT, that I may be found by a court of law to have waived my right to maintain a lawsuit on the basis of any claim from which I have released THE EVENT, its organizers, committee members, volunteers, staff, and participants, as stated above.
13. I give my permission to the volunteer staff at THE EVENT to video-record me during various activities for the purpose of promotion and marketing.  I have been informed that these recordings will not disclose personal or confidential information about me. I can remove my participation in the recordings by simply speaking with the video volunteer staff.  I understand that others in the public may see me on these videos in the future, and I take responsibility for any impact or repercussions that may have on my life.
14. Participation on this weekend experience is voluntary.  Neither MOV as a program, its volunteers, its staff, nor Godfrey Ministries, LLC or The Healing & Recovery Foundation, carry medical insurance for individual participants.  I realize I am required to have my own medical insurance policy to cover possible injuries or accidents.

I acknowledge that I have read and understand the information above, that any questions I have were answered to my satisfaction, and that I voluntarily consent to participate by signing below.