CAMP ROSE: RELEASE FROM LIABILITY

I, First Name *     Last Name * , as the parent/legal guardian, give my permission for my child/children to attend Camp Rose that will be held at Pilgrim Rest Missionary Baptist Church on July 10-13, 2023.

I understand that there are potential risks at this event and further assume all risk of accidental personal injury, sickness, death, damage, and expense because of my child’s/children’s participation in Camp Rose.

In the event my child/children sustain an injury while attending Camp Rose, I give my permission to whoever is in charge to take the steps necessary to stop any bleeding and to administer first aid as needed. I also consent to an X-ray examination, anesthetic, medical (or dental) or surgical diagnosis and treatment and hospital care, and the administration of drugs or medicine to be given to my child/children under the general or specialized supervisor and upon the advice of a licensed physician and/or surgeon.

I also agree for myself, and for my heirs, executors, and administrators, to waive, release, forever discharge and hold harmless Camp Rose, the Church of the Incarnation, Pilgrim Rest Baptist Church, InFaith, Incarnation Place, Roseland Community Center, their clergy, vestry, employees, volunteers (this includes but is not limited to parent volunteers, parent drivers and event hosts) teachers and affiliates from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever and due to any cause whatsoever, including, without limitation, negligence on the part of Camp Rose, the Church of the Incarnation, Pilgrim Rest Baptist Church, Roseland Community Center, their clergy, vestry, employees, volunteers, teachers and affiliates.

I give permission to allow my child/children to be photographed to be used for publicity, promotional, and or educational purposes.

I confirm that I have the right to authorize the foregoing and agree to hold the above-named organizations harmless from any and all liability of whatever nature, which may arise out of or result from such participation.

I have read and understand this Agreement and have willingly placed my signature below as evidence of my acceptance of all the conditions contained here.

Parent/Guardian Signature:   Signature *    

Date:    Date *