Camper Waiver and Release of Liability
In consideration of participation in Mountain Friends Camp, I, as parent/guardian with legal responsibility for my minor child, understand that there are significant risks involved and agree to indemnify and hold harmless Mountain Friends Camp, Intermountain Yearly Meeting, Collins Lake Autism Center, dba. Collins Lake Ranch, and associated officers, directors, staff, volunteers, and landowners from all cost, expense and liability arising out of my child's participation. I understand that there are inherent risks associated with outdoor activities in remote areas at high elevations, and in group living environments. These hazards may include but are not limited to, contracting communicable diseases, and activities related to traditional outdoor pursuits such as hiking, horsemanship and animal care, organized recreation, team building, cooking and outdoor skills. I hereby waive all claims and assume all liability for damage or loss to my person or property, which may be caused by any act or failure to act by the releasees named above arising directly or indirectly from my child's participation in this summer camp. I attest that I have the authority to enroll my child in camp and execute the required documents and that I have obtained any and all other pertinent consents or authorities (including those required by a court decree or order). I agree that it is my responsibility to promptly notify Mountain Friends Camp regarding any legal custody, guardianship or parenting time arrangements or issues, changes to emergency contact and/or persons authorized to pick up child from camp in writing.
Photography and Media Release: I understand that my child may be photographed during the event. I agree to allow their likeness, in photograph and video, to be used by any legitimate use by the releasees, including promotional material and webpages produced by the releasees and accessible via the Internet. I understand that Mountain Friends Camp will never attach names or other identifying information to campers’ images, and that I can request to approve of any images before they are shared.
Medical Release: I give my permission for medical release, should my child be involved in any accident or health damaging situation and should they require medical treatment. I also certify that my child is physically able (and has my permission) to participate in all camp activities, with any exceptions noted on their health history form. I understand any enrollment acceptance is conditional upon completion and receipt of two forms: Participant Health Profile, and Healthcare Provider Recommendations signed by my child’s healthcare provider. I hereby give permission to the camp health staff to provide, seek, or consent to routine health care, to administer prescribed and over-the-counter medications, and seek medical treatment as needed, including but not limited to primary care office visits, x-rays, laboratory studies, anesthesia, surgery, specialty appointments, Emergency Room visits, and/or hospitalization. I hereby give permission to the camp to arrange related transportation. I agree to the release of any medical records necessary for treatment, referral, billing, or insurance purposes. In the event that I cannot be reached in an emergency, I hereby give permission to Mountain Friends Camp staff to secure and administer treatment, including hospitalization, for the person named above. It is also my intention that the appropriate personnel of the camp be treated as my “personal representative” for the purposes of disclosing protected health information. I hereby agree to the disclosure, by health care providers to camp representatives, of protected health information of the person named above as necessary to 1) provide relevant information related to the camper’s ability to participate in camp activities and 2) to provide relevant information to camp representatives as to keep me informed of my child’s health status. I understand that all co-pays or out of pocket medical expenses will be billed directly to myself as the legal parent/guardian.
Transportation and Expedition Release: I understand that Mountain Friends Camp regularly plans programs off-campus, including day trips and 1-2 night backpacking trips. These expeditions may be “walk out” hikes or require transportation in vehicles. All MFC staff driving campers are over 21 with experience and clean driving records, and trips farther than one hour from camp always include staff with wilderness first aid training. I understand there are inherent risks associated with transportation, and with backcountry hiking/camping beyond the reach of motor-vehicles and cellular. I give my permission for my child’s to be transported in a private or rental vehicle driven by adult camp staff and for my child to participate in off-campus expeditions. I understand that it is my responsibility to contact the camp director with concerns or questions, or to revoke permission for specific optional expeditions.
If my minor child (under 18 years of age) is participating in this event, I, the undersigned custodial parent or guardian with legal authority to do so, have consented to their participation and agree to the terms of the waiver and release of liability as set forth above. I knowingly and freely assume all such risks on behalf of my child, both known and unknown, even if arising from the negligence of the releasees or other, and assume full responsibility for my child's participation. I have read this release of liability and assumption of risk agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily on behalf of my child, without any inducement.