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  • YMCA Camp Lake Helena Participation Agreement

    YMCA OF PIERCE AND KITSAP COUNTIES
  • PARTICIPANT INFORMATION

  • BIRTH DATE
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  • Format: (000) 000-0000.
  • NOTIFICATION OF RISKS

  • YMCA Camp Lake Helena program areas may include, but are not limited to, challenge course, sports and games, archery, arts and crafts, swimming, hiking/nature activities, contact with live animals, transportation to/from off-site program locations, and programs such as campfires. Our program areas are designed to meet a wide range of physical abilities and we make reasonable accommodations to serve a diverse population. Activities may indude sitting, walking, running, jumping, throwing, use of archery equipment (bows and arrows), contact with natural elements (sticks, shells, logs, trees, etc.), and craft supplies (paint, glue, dye, and potentially hot liquids such as wax or glue). When utilizing the challenge course, activities may also include participating in group initiatives on low (2 to 3 feet off of the ground) and high (25 to 40 feet off the ground) elements, and climbing and traversing on cables, logs, and ropes while attached to a belay (rope) system.
  • As a participant, you are the best judge of your physical abilities and that of your dependent children. There is a significant element of risk involved in any adventure, sport, or activity associated with the outdoors. If you or your dependent children have a health condition, chronic illness, or injury that might be aggravated by doing these activities, you should not participate in these activities without first consulting a physician. Participation in camp activities is voluntary and participants may choose their level of involvement in all activities. In agreeing to participate, you assume all liability for any physical injuries and/or emotional distress suffered by you and/or your dependent children.
  • WAIVER AND RELEASE OF LIABILITY

  • I am aware that participation in YMCA programs and use of YMCA facilities may involve certain hazards associated with equipment, physical exertion, games, sports, and other programs/activities offered by the YMCA. In consideration of, and as part payment for, the right to use YMCA facilities and participate in YMCA programs, I hold harmless, walve, and release the YMCA ("YMCA" Includes Its employees, volunteers, directors, officers, and agents) for damages of any type, including permanent physical Injuries or death, arising out of the ordinary negligence of the YMCA and also for damages of any type arising out of my own negligence, in whole or in part.
  • By participating in the YMCA Nationwide Membership program, I agree to release the National Council of Young Men's Christian Assocdations of the United States of America, and its independent and autonomous member associations in the United States and Puerto Rico, from claims of negligence for bodily injury or death in connection with the use of YMCA facilities, and from any liability for other claims, including loss of property, to the fullest extent of the law.
  • I assume all risk of injuries and damages associated with my participation in YMCA programs and the use of YMCA facilities including, but not limited to, falls, slips (whether occurring while in the building, offsite as a part of a program, or anywhere else on the YMCA facilities or property, Including adjacent sidewalks, access, and parking areas), contact with other participants, sudden and unforeseen malfunctioning of any equipment, instruction, training, supervision, massage, therapy, classes, or dietary recommendations, the effects of the weather and/or temperature indoor or outdoor, and all other such risks being known and appreciated by me.
  • This release includes foregoing any claim I may have for ordinary negligence arising out of my children's use of YMCA facilities or participation in YMCA programs. I understand that it is my responsibility to obtain a physician's release statement if my child has any physical or mental condition that may impair his or her ability to engage in any of the YMCA's programs or activities.
  • I FULLY UNDERSTAND AND AGREE I AM WAIVING ALL CLAIMS I MAY HAVE AGAINST THE YMCA ARISING OUT OF THE ORDINARY NEGLIGENT ACTS BY THE YMCA, AND I AGREE I WILL NOT BRING A LAWSUIT AGAINST THE YMCA ARISING OUT OF ITS ORDINARY NEGLIGENCE. IF ANY PORTION OF THIS RELEASE IS HELD INVALID, I AGREE THE REMAINDER SHALL CONTINUE TO BE ENFORCEABLE.
  • DATE
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