Camper Waiver of Liability Form

Waiver and Release: IN CONSIDERATION of participating in any Camp Lightbulb event ("Activity"), I—for myself, my guardians, representatives, wards, minor children, and assigns—hereby RELEASE, WAIVE, AND FOREVER DISCHARGE, and COVENANT NOT TO SUE Camp Lightbulb, its administrators, directors, agents, officers, members, volunteers, employees, other Activity participants, insurers, contractors, officials, rescue personnel, sponsors, advertisers, or owners and lessees of premises on which Camp Lightbulb is conducted (collectively, “Releases”) concerning any CLAIMS, LOSSES, DAMAGES, or LIABILITY related to injury, illness, damage, medical expenses, death, or property loss arising from or related to my or my child’s participation in the Activity. This waiver and release extends to claims, losses, damages, or liability caused, or alleged to be caused, in whole or in part BY THE NEGLIGENCE, OMISSION, DEFAULT OR OTHER ACTION OF THE RELEASEES OR ANYONE AFFILIATED WITH THE RELEASES, INCLUDING, BUT NOT LIMITED TO, NEGLIGENT RESCUE OPERATIONS.

Assumption of the Risk: I understand the nature of the Activity and acknowledge that my participation carries inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. Risks vary from one activity to another but range from minor injuries (scratches, bruises, sprains), major injuries (loss of sight, broken bones, joint and muscle injuries, concussions), to catastrophic injuries such as permanent disability, paralysis, and death (“Risks”). I understand that these Risks may be caused by my own actions or inactions, the actions or inactions of others, the conditions in which the Activity takes place, or the NEGLIGENCE OF RELEASEES. I acknowledge that there may be OTHER RISKS or SOCIAL AND ECONOMIC LOSSES not known to me or not readily foreseeable now.

I have read the previous paragraph and I know, understand, and appreciate these and other Risks that are inherent in the Activity. I hereby assert that my participation (or that of minor children) is voluntary and that I knowingly assume all such risks.

In addition, I warrant that I am (or the minor child is) qualified, in good health, and in proper physical condition to participate in the Activity. I agree that if, at any time, I believe that conditions are unsafe or that I am no longer physically qualified, I will immediately discontinue participation in the Activity.

Indemnification and Hold Harmless: I further agree to INDEMNIFY AND HOLD HARMLESS each of the Releasees from any claims, actions, suits, expenses, damages, liabilities, and losses of any kind, including attorney fees, brought as a result of my participation in the Activity, and to reimburse them for any such expenses incurred.

Severability: I further agree that the provisions of this agreement are intended to be as broad and inclusive as is permitted by law and that if any portion is held invalid, that the balance will continue in full force and effect.

Acknowledgement of Understanding: I have read the waiver and release, assumption of the risk, and indemnification, fully understand these terms, and understand that I AM GIVING UP SUBSTANTIAL RIGHTS on behalf of myself and minor, INCLUDING MY RIGHT TO SUE. I acknowledge that I am signing this agreement freely and voluntarily, and intend my signature to be a COMPLETE AND UNCONDITIONAL RELEASE of liability to the greatest extent allowed by law.*

Yes, I agree.

Camper Name*

First NameLast Name

Camper Age*

Camper Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Camper Signature (if over 18)

Date*

Parental Acknowledgment: I, the minor's parent or legal guardian, understand the nature of the Activity and the minor’s experience and capabilities and believe the minor to be qualified, in good health, and ii proper physical condition to participate in it. I have read the waiver and release, assumption of the risk, and indemnification, fully understand these terms, and understand that, on behalf of the minor, I AM GIVING UP SUBSTANTIAL RIGHTS, INCLUDING THE RIGHT TO SUE. I acknowledge that I am signing this agreement freely and voluntarily, and intend my signature to be a COMPLETE AND UNCONDITIONAL RELEASE of liability to the greatest extent allowed by law.*

Yes, I agree.

Parent/Guardian Name*

First NameLast Name

Parent/Guardian Signature*

Date*

Camper Waiver of Liability, Assumption of the Risk, and Indemnity Agreement