Unbreakable Purpose Application, Waiver and Release of Liability Agreement

Unbreakable Purpose Application, Waiver and Release of Liability Agreement - Suffer Up LLC

Please complete this waiver and consent form before participating in the retreat. Your information will be kept confidential.
24 hour Start: September 5th @ 0700

5800 Pilgrim Trail W. Molino, FL 32577
Participant Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Briefly tell us about yourself. (Family, career, hobbies, faith journey, etc.)
Why are you applying to attend Unbreakable Purpose?
What do you hope to gain from this experience?
How would you describe your relationship with Jesus Christ today?
What are your greatest strengths as a man?
Do you have any leadership experience?
What area of your life currently needs the most growth?
What responsibility in your life feels the heaviest right now?
Finish this sentence: “If I continue living exactly as I am today for the next five years…”
How do you typically respond when met with adversity?
What kind of men do you naturally surround yourself with?
This event includes moderate hiking, outdoor activities, limited sleep, heat/ cold exposure, and time in the elements. Are you comfortable participating?
If you have concerns please explain:
What is your “why” today?
This event requires your full participation. Are you willing to:
Please list any allergies, medical conditions, or medications we should be aware of:
Is there anything else you believe we should know about you?
Acknowledgment of Risks and Release of Liability

I acknowledge that I am voluntarily participating in the men’s retreat and understand that certain risks may be involved. I, the undersigned, acknowledge that walking, hiking, running, participating, or volunteering for any Suffer Up event is a potentially hazardous activity that could result in injury or death. I fully understand and voluntarily accept the inherent risks involved, including, but not limited to, the risk of injury, permanent disability, or death, and I assume all such risks associated with my participation. I hereby release the organizers from any liability for injury or loss.
Medical and Physical Condition
Compliance with Event Rules and Host’s Decisions

I agree to comply with all event rules and regulations. I understand that event officials have the authority to deny or suspend my participation at their discretion for any reason, including non-compliance with the rules. I acknowledge that I have read and agree to abide by the event rules, including the prohibition of course cutting, cheating, smoking, alcohol consumption, and use of electronic smoking devices such as juuls, mods, or e-cigs.
Assumption of Risks

I understand and accept that participation in the event involves inherent risks, including, but not limited to: *Physical injuries such as falls or contact with other participants; *Encounters with wildlife, including, but not limited to, alligators, wild boar, antlered deer, raccoons, squirrels, bats, opossums, bears, venomous insects (black widow spiders, fire ants, etc.), venomous reptiles (Eastern Diamondback Rattlesnake, Timber Rattlesnake, Cottonmouth, Copperhead, Coral Snake), pumas, coyotes, and other snakes native to the State of Florida; *Environmental conditions such as high heat, humidity, cold, ice water, traffic, and the conditions of the trail or road; *Any other unforeseen risks, including acts of negligence by myself or other participants. I acknowledge that I have read and understood the risks involved, and I voluntarily assume all responsibility for these risks.
Indemnification
Refund Policy
Media/Photo Consent

I acknowledge and agree that the event organizers may photograph or film participants and attendees during the event. I consent to being photographed or filmed and understand that my image may be used in various media, including but not limited to photographs, videos, and livestreams. I grant the event organizers and their representatives the right to take photographs and videos of me during the event to include any photos related to the event, and to use, reproduce, and distribute these images or recordings for marketing, promotional, advertising, or any other lawful purpose in perpetuity, without compensation or further consent. This includes, but is not limited to, use on websites, social media platforms, print materials, digital course and other promotional content.
Full Understanding and Binding Effect

- By signing this agreement or initialing upon registration, I hereby release, discharge, and covenant to indemnify the organizer(s) of the event, its affiliated organizations and sponsors, employees, officers, directors, agents, associated personnel, landowners, and lessors of premises used to conduct the event. Furthermore, I agree not to sue any of the aforementioned parties and will hold them harmless from any claims, actions, damages, liability, costs, or expenses arising out of my participation in this event.

- By signing below, I affirm that I have carefully read and understood this waiver and release agreement. I acknowledge that it is a legally binding contract, and I agree to its terms for myself, my heirs, personal representatives, estate, and for all members of my family, including minor children, pets, and guests.
Signature
Date Signed

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Unbreakable Purpose Application, Waiver and Release of Liability Agreement - Suffer Up LLC

24 hour Start: September 5th @ 0700