AUTHORIZATION FOR TREATMENT, PARENTAL CONSENT AND RELEASE OF LIABILITY:
As the parent or guardian of the above named applicant, I hereby give my approval and consent for my child to participate in the Falling Spring High School Fall Retreat, Oct 11-13, 2024. In addition, I hereby release The Presbyterian Church of Falling Spring (PCFS), its staff and volunteer leaders, from any and all liability for sickness, accidents, or injuries of any nature or cause whatsoever, including the negligence of PCFS, while participating and/or traveling to and from.
Authorization is also given for appropriate PCFS volunteer leaders to transport the applicant to a doctor’s office or medical facility to secure the services of a physician if needed. I further authorize PCFS volunteer leaders to receive temporary physical custody of my child upon completion of any treatment. I further promise to utilize family insurance for any appropriate medical care and/or hospitalization. I understand attempts will be made to reach me in the event of illness or injury.
Permission is also granted to PCFS to use audio and/or visual recordings for website, bulletin boards, and promotional purposes.
PARTICIPATION AGREEMENT: I acknowledge that participation in the Winter Slam involves inherent risks including, but not limited to: (1) moderate and severe personal injury, (2) property damage, (3) disability, (4) death, and (5) sickness or disease involving the participant and/or their family/or guardians, or (6) emotional injury. I accept and assume full responsibility for these risks as well as any and all other risks involved with the use of PCFS and Winter Slam facilities and participation in this activity.
I also recognize and understand that Covid-19 is a real health threat in our community and that I/my child will be interacting with other students and adults during this trip. He/she may contract Covid-19 despite our efforts to prevent illness. I/my child will act in a responsible way that respects the rights, safety, and dignity of all participants and agree(s) to not visit or participate if I have a fever or symptoms of illness.
If a dispute over this agreement arises, the participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the participant (or parent/guardian) and the activity sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution in accordance with the rules of the American Arbitration Association.
By signing, I/we understand and agree to this waiver. (Click next to sign)
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