Authorization to participate in camp activities away from camp premises: I, hereby give permission for my child to go on field trips away from camp premises, whether on foot or by vehicle.

Waiver & Liability Release

I hereby waive, release, and hold harmless Deaf Youth Camp/Baptist Ridge, its officers, employees, agents, representatives, volunteers, heirs, executors, and assigns from all liability for personal injury, including death, as well as all property damage or loss arising out of my/my child’s participation in this Retreat Program and any travel/transportation related to this Retreat Program, whether paid for by myself or by Deaf Youth Camp/Baptist Ridge. I understand that this release and indemnification releases liability for the conduct of Deaf Youth Camp/Baptist Ridge and its officers, employees, agents, representatives, volunteers, heirs, executors, and assigns.

This release is intended to discharge in advance Deaf Youth Camp/Baptist Ridge, its officials, officers, employees, volunteers, and agents from liability, even though that liability may arise out of perceived negligence on the part of persons mentioned above. It is understood that some recreational activities involve an element of risk or danger of accidents, and knowing those risks, I hereby assume those risks. It is further understood and agreed that this waiver, release and assumption of risk is to be binding on my heirs and assignees.

Parental Consent (Complete if applicant is under 18)

For the safety and general welfare of all campers, the Deaf Youth Camp reserves the unrestricted right to dismiss a camper whose conduct or influence, in the opinion of the Director is detrimental to the best interest of the camp.

The Deaf Youth Camp/Baptist Ridge is not responsible for camper’s articles of clothing or personal belongings. Please have YOUR CHILD’S NAME ON ALL CLOTHING ITEMS. It is strongly recommended that campers Do Not BRING valuable items (cell phones, iPods, electronic games or devices, tablets, NOOK, etc.).

I have read and understood the foregoing registration liability release and parental consent form, and agree to all of its terms and conditions.

 

Photography Consent

The undersigned gives permission to Deaf Youth Camp to use photographs, printed materials, video recordings and other similar media of the Deaf Youth Camp Participant for fundraising and/or marketing purposes. On occasion, participant photographs may be included in promotional videos, websites, Deaf Youth Camp albums, newsletters or our Information Folders, which contain information given to churches, associations, Interpreters, agencies and organizations for the sole purpose of promoting Deaf Youth Camp. Deaf Youth Camp respects the privacy of its participants and does not allow unauthorized visitors to photograph or video the camp or its participants without permission from the Director.

I further waive any and all rights to inspect or approve the photograph, videotape, printed materials, and other similar media of my and/or my minor child(ren)’s or ward(s)’ name(s) and/or likeness(es), including any written article, script, caption or other writing that may accompany such use of my and/or my minor child(ren)’s or ward(s)’ name(s) and/or likeness(es). I hereby, for myself, my minor child(ren) or ward(s), heirs, and executors, waive, release and forever discharge the Deaf Youth Camp/Baptist Ridge and its employees, agents, counselors, teachers, representatives, successors and assigns, from and against any and all liability, claims, losses, costs, expenses or damages for libel, slander, invasion of privacy, conversion, defamation, appropriation of likeness or any other claim based on the use of my and/or my minor child(ren) or ward(s)’ name(s) and/or likeness(es) in any such materials.

Please list as much as possible about your insurance and the deductible. Submit a current picture, camp registration and complete Camper Health form and scan a copy of insurance card. 

MAIL check/money order for registration to:

Deaf Youth Camp Registration

PO Box 300827

Kansas City, MO 64130

Registration fee: $100.00

 Checks should be payable to: Deaf Youth Camp

DEADLINE for receiving application and fee is May 1, 2025

REFUND POLICY

 No refund after May 20, 2025

I understand that in the event of the withdrawal, dismissal or absence of the camper after May 23, 2025, no portion of the registration fee will be refunded or waived. There will be no refund to families or guardians, whose camper is withdrawn or is dismissed during the retreat. 

I have read and agreed to the terms of the Refund Policy.

Lost/Stolen Policy:

Deaf youth Camp is not responsible for your child’s lost or stolen items including hearing aid/cochlear implants, pager, glasses, camera, jewelry, flashlight, clothing items, electronic devices and games, cell phone, any money, cochlear batteries & chargers and etc.

It is strongly recommended that campers Do Not bring valuable items (cell phones, iPads, electronic games or devices, tablets, NOOK, money, etc.). Camper is responsible for his/her personal belongings including but not limited to hearing aids, cochlear implants, glasses. It is advised to for camper to put his/her name on all clothing and personal items.

ADMINISTRATION OF OVER-THE-COUNTER MEDICATIONS

The following information must be completed by parent/guardian in order for any over-the-counter medicationb to be administered at Deaf Youth Camp. All medications will be administered by a nurse.

The over-the-counter medications will be available in the Nurse's Office during camp. In order for your child to receive medication, parents must authorize each medication by marking the correct medication name below. All medications will be administered according to the package dosage directions only. Campers are not permitted to self-medicate with ANYover-the-counter medications while at camp.

You may choose to decline any medication to be given without verbal/phone consent from you to the camp nurse. If that is your preference, please mark REFUSE MEDS option on the list below.

CONSENT FOR TREATMENT

In the event I cannot be reached in an emergency, I hereby give permission for the physican selected by the camp administrator, camp nurse or emergency medical personnel, or surgeon, in case of a sudden illness or injury while participating in the activities at Deaf Youth Camp, to hospitalize, secure proper treatment for and to order injection, anesthesia or surgery for my child and will accept all of the expenses of emergency medical or surgical treatment.

It is understood that Deaf Youth Camp will provide no medical insurance for such treatment, and that the cost thereof will be at my expense.

I have provided typed information to Deaf Youth Camp of any special medical needs and diagnosis of my child and have provided them with complete and accurate instructions regarding those needs, including any necessary and lawfully prescribed drugs for my child. I hereby authorize Deaf Youth Camp and Baptist Ridge and its employees and agents to dispense medications and attend to other special needs of my child.

I give Deaf Youth Camp's nurse permission to administer all medicines listed as per directions on the container and any information regarding the diagnosis of my child.

Please check or list all allergies or special dietary needs.

Please select below the level of discomfort to the allergy reaction to these foods from Uncomfortable to  Life Threatening. 

Please attach a picture of your son/daughter so we can recognize them in line for the meal times. Thank you!

Please write your son/daughter's name on his/her food brought to camp and we will give to staff to take to the kitchen.

Event: Deaf Youth Camp                 Date: June 22-27, 2025

Location: Baptist Ridge Camp

I give permission for my child/children to be transported in a motor vehicle driven to & from Baptist Ridge, any events and other Deaf Youth Camp approved activities at other locations during the dates indicated and returned home on June 22-27, 2025. I understand that my child is expected to follow all applicable laws regarding riding in a motor vehicle and is expected to follow the directions provided by the driver and/or other adult volunteers.

I have read, understand, and discussed with my child that:

(1) They will be traveling in a motor vehicle driven by an adult, and they are to wear their safety-belt while traveling & may wear a face mask;

(2) They are expected to respect each other, the vehicles they ride in, and the people they travel with during the trip;

(3) Riding in a motor vehicle may result in personal injuries or death from wrecks, collisions or acts by riders, other drivers, or objects;

(4) They are to remain in their seats and not be disruptive to the driver of the vehicle.

I recognize that by participating in this activity, as with any activity going or coming to Baptist Ridge involving motor vehicle transportation, my child may risk personal injury or permanent loss. I hereby attest and verify that I have been advised of the potential risks, that I have full knowledge of the risks involved in this activity, and that I assume any expenses that may be incurred in the event of an accident, illness, or other incapacity, regardless of whether I have authorized such expenses. As a condition for the transportation received, I, for myself, my child, my executors and assigns, further agree to release and forever discharge Deaf Youth Camp, Baptist Ridge, officers, and volunteers from any claim that I might have myself or that I could bring on my child’s behalf with regard to any damages, demands or actions whatsoever, including those based on negligence, in any manner arising out of this transportation. I have read this entire waiver and permission form, fully understand it, and agree to be legally bound by its terms.

I. Deaf Youth Camp will always endeavor to reasonably and to the best of our ability follow state and local standards of conduct and Baptist Ridge has put in place reasonable preventative measures to reduce the spread of COVID-19 and its variants at its facility. Deaf Youth Camp recognizes that social distancing is not always possible during the camp but will encourage it whenever possible. However, even though such standards will be reasonably followed, and reasonable measures put into place, Deaf Youth Camp nor Baptist Ridge cannot guarantee that you or your child(ren) will not become infected with COVID-19 or its variants. Further, you understand and acknowledge that attending Deaf Youth Camp at Baptist Ridge could increase your risk and your child(ren’s) risk of contacting COVID-19 or its variants.

II. You further agree that for each day your child(ren) attends Deaf Youth Retreat,

You certify the following:

1. I take full responsibility for assessing my child(ren) for symptoms of COVID-19 each day before they are dropped off at the pickup site OR dropped off at Baptist Ridge.

2. I will not allow my child(ren) to attend camp in which they meet CDC criteria for symptoms of COVID-19 and its variants as follows:

One or more of the following:

*Cough

*Chills

*Sore Throat

*Shortness of Breath

*Muscle Pain

*Loss of taste or smell

*Difficulty breathing

*Headache

*Fever of 100.4 or more

3. If my child(ren) has been diagnosed with COVID-19 or has symptoms of COVID-19 or any of the COVID related variants I will not allow my child to attend Deaf Youth Camp until I talk to the Camp Director.

4. My child(ren) has not come into contact with anyone diagnosed with COVID-19 or any COVID variants for 7 days prior to the day my child(ren) is attending Camp.

5. My child(ren) has not traveled outside of the United States or has come in contact with anyone who has traveled outside of the United States in the past 7 days.

III. You further certify the following: I have discussed all the applicable requirements, practices, and procedures with my child(ren), including but not limited to the requirements to wear a mask, wash hands to the greatest extent possible. I will immediately notify the Camp Director of any symptoms of the corona virus/variants or if a corona virus infection is confirmed or presumed in my child(ren), myself or a household member. I agree that myself and my child(ren) will act in compliance with the most current guidelines.

IV. By signing this agreement, I acknowledge the contagious nature of COVID-19 and its variants and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending the camp or similar activity and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 and its variants at the Spring Retreat or similar activity may result from the actions, omissions, or negligence of myself and others, including but not limited to, Deaf Youth Camp and Baptist Ridge, including volunteers and employees, and program participants and their families. I VOLUNTARILY AGREE TO ASSUME ALL THE FOREGOING RISKS AND ACCEPT SOLE RESPONSIBILITY FOR ANY INJURY TO MY CHILD(REN) OR MYSELF (INCLUDING BUT NOT LIMITED TO, PERSONAL INJURY, DISABILITY, AND DEATH), ILLNESS DAMAGE, LOSS, CLAIM, LIABILTY, OR EXPENSE, OF ANY KIND, THAT I OR MY CHILD(REN) MAY EXPERIENCE OR INCUR IN CONNECTIONS WITH DEAF YOUTH CAMP PROGRAMMING (“CLAIMS”) AND BAPTIST RIDGE, ON MY BEHALF, AND ON BEHALF OF MY CHILD(REN), I HEREBY RELEASE, COVENANT NOT TO SUE, DISCHARGE, AND HOLD HARMLESS DEAF YOUTH CAMP AND BAPTIST RIDGE, FORMER OFFICERS, EMPLOYEES, VOLUNTEERS, SERVANTS, AGENTS, AND WAIVE ANY AND ALL RIGHTS TO ASSERT SUCH CLAIMS, INCLUDING ANY AND ALL LIABILITIES, ACTIONS, DAMAGES, COSTS, OR EXPENSES OF ANY KIND OF EVERY NATURE ARISING OUT OF OR RELATING THERETO.

V. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Deaf Youth Camp or Baptist Ridge, its employees, agents and representatives, whether a COVID-19 and/or COVID Variant infection occurs before, during, or after participation in any Deaf Youth Camp retreat or similar program. I agree that presentation of this Release and Waiver constitutes a complete and affirmative defense to any action asserting any Claims and that such action shall be dismissed without prejudice upon presentation of this Release and Waiver.

I HAVE CAREFULLY READ THIS CONSENT FORM AND LIABILITY WAIVER, FULLY UNDERSTAND ALL OF ITS TERMS, UNDERSTAND THE RIGHTS THAT MY CHILD(REN) AND I FORFEIT BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

PLEASE READ CAREFULLY!!!

Please read, sign and date below. 

In consideration of the services of Mid-Lakes Baptist Association & Deaf Youth Camp (DYC), its agents, owners, officers, volunteers, participants, and all other persons or entities acting in any capacity on its, myself, my children, my parents, my heirs, assigns, personal representative and estate as follows:

I acknowledge and agree that:
1. I will wear protective and safety gear prescribed by Mid-Lakes Baptist Association & DYC, knowing, however, that protective gear does not and cannot guarantee physical safety.

2. I am at all time fully and solely responsible for my own safety and well being while engaging in activities offered or provided by Mid-Lakes Baptist Association & DYC, and in transit to and from such activities. I accept and assume all risks connected with activities offered and/or provided by Mid-Lakes Baptist Association & DYC.

3. I understand and acknowledge there are risks of personal injury, death, and property damage while participating in the instructional activities, and trips offered by Mid-Lakes Baptist Association. Including risks posed by travel to such activity. My participation in these activities is purely voluntary, and I elect to participate in these activities in spite of the risks.

Release of liability, waiver of claims and indemnity agreement:
In consideration of permission to participate in activities with Mid-Lakes Baptist Association and DYC, I hereby acknowledge and agree to the following by execution of this document:

1. I hereby release and hold harmless Mid-Lakes Baptist Association & DYC, its officers, directors, agents and volunteers from any liability whatsoever for any and all injury, disability, death, or loss or damage to person or property, whether caused by active or passive negligence or otherwise, as well as from any claims or causes of action that I, my estate, heirs, survivors, executors, or assigns may have for personal injury, property damage, or wrongful death arising from activities offered or provided b y Mid-Lakes Baptist Association and DYC.

2. By my participation in these activities and for use of equipment, I hereby assume all risks and dangers and all responsibility for any losses and/or damages, whether caused in whole or in part by the negligence or other conduct of Mid-Lakes Baptist Association, DYC, agents, officers, directors, and volunteers, or by any other person.

3. I certify that I have no medical or physical condition which could interfere with my safety while participating in these activities, or else I am willing to assume, and bear the costs of, all risks that may be created, directly or indirectly, by such condition. I agree to wear a properly fastened personal floatation device at all times while in the water, and to use such other safety equipment as may be provided to me by Mid-Lakes Baptist Association & DYC.

 

4. I understand and agree that should emergency rescue evacuation become necessary, the expenses are my sole responsibility and not that of Mid-Lakes Baptist Association or Deaf Youth Camp.

***Read this form completely and carefully. You are agreeing to engage in a potentially dangerous activity. You are agreeing that, even if Mid-Lakes Baptist Association and Deaf Youth Camp uses reasonable care in providing this activity, there is a chance you may be seriously injured because there are certain dangers inherent in this activity which cannot be avoided or eliminated. By signing this form you are giving up your right to recover from
Mid-Lakes Baptist Association and Deaf Youth Camp in a lawsuit for any personal injury to you or any property damage that results from the risks that are a natural part of the activity. You have the right to refuse to sign this form, and Mid-Lakes Baptist Association & Deaf Youth Camp has the right to refuse to let you participate if you do not sign this form.

I have carefully read this RELEASE OF LIABILITY AND WAIVER AGREEMENT, and fully understand it. I understand this is a release of waiver of liability and by signing this agreement I am giving up important legal rights.

Parent or guardian if participant is under 18 years old: 

If we are unable to contact person name above, please give another contact person: