PKCC 2025 Release Form: Oahu Baptist Network Youth Camp
This form is to be completed by all Adult Participants and Parents/Legal Guardians of Participant(s). Please read carefully before signing this form.
Participants information (Parents/Guardians can fill out multiple entries for their children):
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EVENT DESCRIPTION: I am/My child is a willing participant in an event sponsored by Oahu Baptist Network Youth Camp being held at Pu’u Kahea Conference Center (“PKCC”). I understand that the Group has planned the Event and is responsible for the content and activities selected for the Event and that PKCC is only providing accommodations and facilities for the Event.
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I understand
ASSUMPTION OF RISK: I hereby expressly and specifically assume all risks of injury, loss, or damage, which I or my child might sustain while participating in the Event and related Activities.
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I understand
INDEMNIFICATION AND RELEASE OF LIABILITY: I do further hereby release and discharge from liability and agree to defend, indemnify, and forever hold harmless Hawaii Pacific Baptist Convention (HPBC) and Pu’u Kahea Conference Center (PKCC) , and the volunteers and employees, from any and all causes of action arising from or relating to my/my child’s participation in the Event. I understand that I am/my child is solely responsible for my/ his or her personal effects and property and I will hold the Hawaii Pacific Baptist Convention, Pu’u Kahea Conference Center, volunteers, and employees harmless in the event of theft or loss resulting from any source or cause.
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I understand
ADULT VERIFICATION: I verify that I am at least 18 years of age when signing this document and, therefore, an adult.
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Yes, I am the PARTICIPANT and I am at least 18 years of age.
Yes, I am the PARENT/LEGAL GUARDIAN of the minor Participant. Parental Authorization (below) is required.
MINOR PARTICIPANT – PARENTAL AUTHORIZATION:As a PARENT/LEGAL GUARDIAN of the minor Participant(s), I give my permission for the minor(s) listed to participate in the Event and agree to the assumption of risks, Indemnification and Release of Liability. I accept responsibility for all medical, health and/or liability expenses which may arise from the minor’s involvement in the Event. I authorize Pu’u Kahea Conference Center’s designated representative(s) to serve as our attorney-in-fact and vest each of them with authority to authorize any necessary medical treatment for our minor child.
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I understand (For PARENT/LEGAL GUARDIAN)
Not applicable because the Participant is at least 18 years of age (For only ADULT PARTICIPANT)
Signature of Adult Participant or Parent/Legal Guardian: I am an ADULT PARTICIPANT and/or PARENT/LEGAL GUARDIAN of the minor, and I am authorized to sign this form on behalf of myself or any other parent/legal guardian of the minor. By signing my name below using e-signature, I agree to its terms, and have effectively signed the release.
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Your Name (Adult Participant and/or Parent/Guardian):
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First Name
Last Name
Today's Date
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Month
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Day
Year
Date
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