• Consent, Indemnification, and Acknowledgement of Risks

    Consent, Indemnification, and Acknowledgement of Risks

  • Buckner International dba Camp Buckner requires that all camp participants, and if the Camper is a minor, his or her parent or legal guardian, or managing conservator of a minor child who participates in activities while staying at Camp Buckner, to read and sign this Consent, Indemnification, and Acknowledgement of Risks form and return it to the camp staff before being permitted to attend and participate in Camp Buckner programs and activities.

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  • IN CONSIDERATION of the right to attend and participate in the activities described herein, the Camper, and if the Camper is a minor, his or her parent, legal guardian or managing conservator, hereby acknowledge, agree, and consent to the following:

    As a result of COVID-19 individuals and organizations put into place measures to mitigate the risk of transmission of COVID-19 and its effects. Camp Buckner continues to operate under its COVID-19 Mitigation Plan with the primary goal of safety and protection for our campers and staff; however, Camper may still risk contracting the virus while at Camp.

    1. Agrees to follow and be subject to all rules, policies and procedures of Camp Buckner regarding all activities as contained in the attachment, Camp Buckner Guest Policies and Procedures, and/or posted in the camp or conveyed by camp staff.

    2. Acknowledges that there is an element of risk involved in Camper activities and that such activities may include, but not be limited to activities involving Swimming, Blob, Water Slide, Canoeing, Kayaking, Archery, Hiking, Sports of all kind, Horseback Riding, Ropes courses, Climbing Wall, Rock climbing, Biking, and interactions with fellow campers, etc. I understand that these activities may expose Camper to greater than normal risks due to characteristics of the activity and uncontrollable nature of surrounding elements. These risks may include equipment malfunction, loss of control, collisions, obstacles, variation of terrain, unexpected actions, and exposure to COVID-19 virus.

    I understand that these risks may include physical injury and psychological damage and/or injury including death, which may occur or result from participation in such camp activities. I understand that Camper may act in a negligent manner that may contribute to injury to himself/herself or others, such as failing to maintain control, not acting within his or her abilities, or not following rules and instructions.

    I acknowledge and state that I accept and assume these risks and dangers and assume full responsibility for Camper’s safety and well-being while he or she is participating in such activities. I, for myself, the Camper and on behalf of our heirs, assigns, personal representatives and next of kin, hereby release, waive, hold harmless, indemnify and discharge Buckner International dba Camp Buckner, its officers, directors, employees, agents, affiliated organizations and representatives from and against any and all claims, demands, expenses (including attorney fees) and liability or loss, of whatever kind and nature, including injury, disability or death of the Camper and loss or damage to person or property, and whether caused by the negligence of Camp Buckner, its officers, directors, employees, agents, affiliated organizations or otherwise which may arise in connection with participation in Camp Buckner programs and activities.

    3. Grants and consents to Camp Buckner the right to the use of the Camper’s name, photographs, films, recordings and likeness of the Camper while he or she is participating in the Camp Buckner activities for any purposes connected to promoting the purposes and goals of Camp Buckner, but not for any commercial exploitation or any other improper purposes, and consents to Camp Buckner use, reproduction, publishing and distribution of same in accordance with the permitted purposes set forth in this paragraph.

    This Consent, Indemnification, and Acknowledgement of Risks shall not be amended, supplemented, or abrogated without the written consent of Camp Buckner.

  • The Camper (and, if the Camper is a minor, his or her parent, legal guardian or managing conservator) has read this Consent, Indemnification, and Acknowledgement of Risks and understands the contents.

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  • If camper is a minor (17 and younger), the signature(s) of his/her parent, legal guardian, or managing conservator is required below:

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  • Should be Empty: