2025 PVCC Women's Retreat Registration, Waiver & Release Form 9.26-28.25 Logo
  • Prairie View Christian Camp

    2025 Women's Retreat Registration, Waiver And Release Form
  • September 26-28, 2025

    Early Bird Discount Deadline 9/5/25

  •  - -
  •  - -
  • I understand that participants attending a camp session at Prairie View Christian Camp will be offered an opportunity to participate in multiple recreation options including, but not limited to, swimming, paintball, rock climbing, rappelling, and zip line. Additionally, Junior High and High School participants may be offered an opportunity to Trap Shoot. I fully understand and acknowledge that 1. risks and dangers exist in the participation in and use of high ropes elements and operating a firearm; 2. that participation in such activities and/or use of such equipment may result in injury or illness including, but not limited to, bodily injury, disease strains,fractures, partial and/or total paralysis, eye injury, blindness, heat stroke, heart attack, death, or other ailments that could cause serious disability; and 3. by giving myslef/my child permission to participate in these activities and use this equipment, I assume all risks and dangers and all responsibility for any losses and/or damages incurred while participating in these activities.

  • Parent or Participant over 18 years of age Initials field.

  • To the best of my knowledge, myself/my child is physically and emotionally able to take part in the camp program. In the event of a medical emergency, I give permission to the volunteer medical person selected by the camp management to do whatever is necessary for the health of my child as named on this form. I herebyrelease the camp from any responsibility other than normal supervision and care. In case of an accident, I will not hold Prairie View Christian Camp, their staff members, management, or officers liable. I have reviewed this form and certify that all appropriate medical information is included.

  • Parent or Participant over 18 years of age Initials field.

  • I also give my permission for any appropriate photographs/videos to be used for future Prairie View Christian Camp promotional purposes.

  • Parent or Participant over 18 years of age Initials field.

  • I recognize that this is a Christian camp, that the Bible will be studied, and that camp conduct will be expected that is consistent with Christian Values.

  • Parent or Participant over 18 years of age Initials field.

  • I am aware of the dangers of attending this event on this particular date. I promise not to hold Prairie View Christian Camp, its officers, agents, or employees liable or pursue legal action against them. This waiver absolves Prairie View Christian Camp of any duty for injuries sustained on the premises before to, during, or after the activity.
    By signing this agreement, I agree to hold Prairie View Christian Camp completely harmless, including financial responsibility for any injuries sustained, regardless of the cause or circumstances.
    I will do all in my power to obey staff & volunteers and all safety requirements, and I will seek clarification if necessary.

  • Powered by Jotform SignClear
  •  - -
  • REGISTRATION CONFIRMATION AND PAYMENT

    Thank you for signing up to join us at this Women's Retreat!  Please confirm your options below before paying.

    Registration Option: {pleaseChoose}

    Early Bird Discount: ${totalEarly}

  • prevnext( X )
    USD
    Credit Card Details
  • Should be Empty: