Summer Camp Registration

Parent/Guardian Information

Emergency Information

Medical Release and Authorization / Permission to Treat 

This form exists in case of medical emergency which would allow a medical professional to treat a participant if the parent guardian cannot be reached by phone and they needed life-saving care. Please know this is beyond unlikely but we are required to provide as a precautionary measure. 

As Parent and/or Guardian of the named participant, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed and said parent or guardian cannot be reached by phone. 

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment and x-ray examination for the named participant. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to GoodLyfe and Gillette Family Foundation and its affiliates including Directors, Leaders, and Camp Staff to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

CAMP GOODLYFE Waiver -

*Please note waiver is a standard release and the risks mentioned in waiver are highly unlikely. GoodLyfe aims to provide the safest and best experience for all campers.

Safe practices, proper supervision, and thoughtful activity list are all used to ensure quality camper experience with gaurdian/parent peace of mind. 

Informed Consent, Acknowledgement, Release and Waiver

I OR MY CHILD AM VOLUNTARILY PARTICIPATING IN CAMP GOODLYFE
(“THE ACTIVITY”) AND I OR MY CHILD AM PARTICIPATING IN THE ACTIVITY
ENTIRELY AT MY/OUR OWN RISK. I AM WELL AWARE OF THE RISKS
ASSOCIATED WITH TRAVELING TO AND FROM, AS WELL AS PARTICIPATING IN,
THE ACTIVITY, WHICH MAY INCLUDE, BUT IS NOT LIMITED TO, DAMAGE TO
PROPERTY, PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS,
DISFIGUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING
PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND
THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN, MY CHILD’S,
OR OTHERS’ NEGLIGENCE, CONDITIONS RELATED TO TRAVEL, THE CONDITION
OF THE LOCATION(S) OF THE ACTIVITY, OR THE CONDITION OF EQUIPMENT OR
STRUCTURES LOCATED AT THE ACTIVITY. NONETHELESS, I ASSUME ALL
RELATED RISKS, BOTH KNOWN OR UNKNOWN TO ME, OF MY OR MY CHILD’S
PARTICIPATION IN THE ACTIVITY, INCLUDING TRAVEL TO, FROM, AND DURING
THIS ACTIVITY.
In consideration of the risk of injury while participating in the Activity, and as
consideration for the right to participate in the Activity, I hereby, for myself (and for purposes of
this Agreement, any references to “I” or “my” shall be deemed to include “my child” or “my
child’s”, as applicable), my heirs, executors, administrators, assigns, or personal representatives,
knowingly and voluntarily enter into this Informed Consent, Acknowledgement, Release and
Waiver (this “Instrument”) and hereby waive any and all rights, claims or causes of action of any
kind whatsoever arising out of my participation in the Activity, and do hereby release and
forever discharge the following parties: Camp Goodlyfe, The Gillette Family Foundation,
Genesis Land LLC, an Alabama limited liability company, Genesis Capital LLC, an Alabama
limited liability company, Beth King Gillette, Quentin Gillette, Isabella Gillette, Jackson Terry,
their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives,
predecessors, successors, and assigns (collectively, the “Released Parties”), for any damage to
property or physical or psychological injury, including, but not limited to, illness, injury,
paralysis, death, damages, economic or emotional loss, that I or my child may suffer as a direct
result of participation in the Activity, including traveling to and from an event related to this
Activity, arising from use of equipment and materials at the Activity and/or arising out of,
resulting from, or in any way caused by any negligence, actual or passive, of the Released Parties
or anyone using the equipment or structures at the Activity or the premises where the Activity is
located.
I agree to indemnify and hold harmless the Released Parties against any and all claims,
suits, liability, or actions of any kind whatsoever for liability, damages, compensation, costs, or
otherwise brought by me, anyone on my behalf or otherwise related to my participation in the
Activity, including attorney’s fees and any related costs if litigation arises pursuant to any claims
arising from my participation in the Activity. If any of the Released Parties incurs any of these
types of expenses, I agree to reimburse the Released Parties to such extent.

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I acknowledge that the Released Parties are not responsible for any personal items of an
individual at the Activity that are lost, stolen or damaged. I acknowledged that the Released
Parties have advised me not to bring valuable personal items to the Activity.
I acknowledge that the individuals assisting with the Activity are volunteers and do not
have professional training regarding the Activity. Further, any instructions concerning
movement or techniques related to the Activity provided by said individuals assisting with the
Activity are purely conversational and opinion based and are not meant to be instructional and
that I should seek professional opinions from other sources for instructional guidance.
I ACKNOWLEDGE THAT THE ACTIVITY MAY INVOLVE A TEST OF A
PERSON’S PHYSICAL AND MENTAL LIMITS AND MAY CARRY WITH IT THE
POTENTIAL FOR DEATH, SERIOUS INJURY, AND PROPERTY LOSS. The risks may
include, but are not limited to, those caused by terrain, facilities, temperature, weather, lack of
hydration, condition of participants, equipment, vehicular traffic, and actions of others,
including, but not limited to, participants, volunteers, spectators, coaches, event officials, event
monitors, and/or producers of the event.
If any term or provision of this Instrument is held to be illegal, invalid or unenforceable,
or the application thereof to any person or circumstance shall to any extent be illegal, invalid or
unenforceable under present or future laws, then and in such event, it is the express intention of
the parties that the remainder of this Instrument, or the application of such terms, clauses or
provision other than to those as to which it is held illegal, invalid or unenforceable, shall not be
affected thereby, and each term, clause or provision of this Instrument, and the application
thereof, shall be legal, valid and enforceable to the fullest extent permitted by law.
This Instrument constitutes the entire agreement of the parties with respect to the subject
matter of this Instrument and supersedes all prior agreements, understandings, negotiations,
statements, promises and discussions, oral and written, between the parties hereto with respect to
the subject matter of this Instrument.

Confirmation

I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS INSTRUMENT AND
FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE
TO RELEASE AND DISCHARGE THE RELEASED PARTIES, FROM ANY AND ALL
CLAIMS OR CAUSES OF ACTION AS PROVIDED HEREIN AND I AGREE TO
VOLUNTARILY WAIVE ANY RIGHT THAT I OTHERWISE MAY HAVE TO BRING A
LEGAL ACTION FOR PERSONAL INJURY OR PROPERTY DAMAGE. I
ACKNOWLEDGE THAT I HAVE HAD AN OPPORTUNITY TO CONSULT LEGAL
COUNSEL CONCERNING THIS INSTRUMENT.

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Media Release Form

 This form exists to allow GoodLyfe usage of video and photo content from camp for future promotional use if you or your child is pictured. We are cautious of what goes online and will take great care to make sure content is used appropriately. 

I hereby allow GoodLyfe to use photo or video content taken of myself or my child during camp for public use, including, website usage, social media usage, print, and promotional use.