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CBC - Climbing Program Waiver

CBC - Climbing Program Waiver

Please note that participants under the age of 18 need a parent or guardian to complete this form. You will have the opportunity to receive a copy of your submission at the end of this form. The Adventure Programs and Outdoor Education programs facilitated through Camp Beech Cliff may involve a variety of activities ranging from sitting or standing still to warm-ups and rigorous physical activities on trails, indoors, on natural or on human made structures. All activities have the potential to cause physical and/or emotional harm. For your enjoyment and to help us make sure that we meet your goals and ability level, please communicate with us to make sure you have registered for an appropriate program. Our goal is for everyone to have fun, take positive risks, and learn something while they are at it. The level of participation in these programs is, at all times, completely voluntary and up to the individual’s choice. In addition, certain health/medical information must be made known to the instructor(s) conducting programs, so that they are prepared to respond appropriately if the need arises. This information will be read by your facilitators ONLY and will be kept in strict confidence. Please do not hesitate to ask if you have questions. Thank You.
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    Name of Adult completing the form
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    Please enter the name of an individual we should contact on your behalf in case of an emergency
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    Please enter the best number to reach your contact in an emergency
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    If yes, you will be prompted to provide details next.
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    Adventure Programs often involve physically and emotionally demanding activities in an outdoor and sometimes indoor setting. It is required that you read the following very carefully, make sure you understand it, and sign it before you begin participating in the program. Please contact us if you have any questions. Thank You. I am fully aware that the programs that I am choosing to participate in may include rigorous physical activities. I am also aware that there are risks of serious physical injury or harm from participating in these programs. I voluntarily elect to participate in the program and to assume all risks of injury or harm that could result from participation. I understand that the level of participation in the programs is at all times completely voluntary and up to the individual’s choice. I agree that I will not make a claim or bring suit against Camp Beech Cliff, or Camp Beech Cliff MDI, LLC, it’s employees, agents, officers, directors or consultants, regarding any personal injury or property damage I or my child may incur while participating in the program or using the facilities, and hereby release the aforementioned from any responsibility or liability for any injury or harm. I further agree to defend, hold harmless and indemnify the aforementioned from any and all such claims. I have read and understand this release of liability. I voluntarily sign it. I agree that the substantive laws of Maine govern this document and other aspects of my relationship with Camp Beech Cliff and Camp Beech Cliff MDI, and that any mediation, suit, or other proceeding must be filed or entered into only in Maine. I hereby give permission for the leaders of the stated program and organization to administer medical assistance equivalent with their standard of care and/or to seek appropriate medical assistance for the participant listed. I affirm that my health is good, and that I am not under a physician’s care for any undisclosed condition that bears upon my fitness to participate in adventure programs or outdoor education programs here at the outdoor center at Camp Beech Cliff. IF UNDER 18, MUST BE SIGNED BY PARENT/GUARDIAN.
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    At Camp Beech Cliff, we frequently take photographs of participants in our programs. These photographs help us design and produce brochures, posters, web updates and other marketing pieces that help us communicate what we do at CBC. Would you be willing to let Camp Beech Cliff use a photograph of your child for marketing purposes? Please sign below if it is OK with you.We respectfully understand if you choose not to sign. For good and valuable consideration, I hereby consent to and authorize the reproduction, publication, and use by Camp Beech Cliff and their successors and assigns, for advertising, commercial, and promotional use and any other purpose the photo, picture, or likeness of my child.
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    While this form is being completed on a secure site (https), please note that CBC can not be responsible for personal information sent over insecure email networks. Our office can provide hard copies if you prefer.
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