General Release Waiver (Parent or Guardian must complete for applicants under the age of 18)
The undersigned, or on behalf of said minor, has asked Pine Valley Camp (hereinafter “PVC”) to be allowed to participate in the activities offered at PVC. Activities may include but are not limited to Archery, Boating, Canoeing, Waterslide, Pedal carts, Swimming Pool, Horseback Riding, and Rock Climbing. The undersigned acknowledges that the activity involves physical exertion and other risks; is aware of the possibility of risk of injury to individuals participating or observing the activities, including, but not limited to permanent disability including blindness, loss of hearing, or death does exist; Recognizes the need to participate in the activities according to the rules which have been given and to follow directions given by any Staff Member, Counselor, Crew Member, or Volunteer; Understands that it is each participant’s responsibility to wear any safety gear deemed necessary by PVC; Warrants and acknowledges that his/her physical and mental condition will enable him/her to participate safely in the activity. Understands that a horse, regardless of its training and usual past behavior and characteristics, may act or react unpredictably at times based upon instinct or fright, and this is an inherent risk assumed by the participant. The undersigned, or on behalf of said minor, hereby waives and releases any and all claims, demands, actions, causes of action and rights, (contingent, accrued, inchoate, or otherwise), defend, and hold PVC harmless from and against any and all claims, liabilities, expenses, damages, losses, causes of action, and suits (including, without limitation, attorneys’ fees and costs) arising out of, or any way related to the participation in activities at PVC, whether caused by PVC’s active or passive negligence or otherwise. The undersigned, or on behalf of said minor, gives permission for the transportation of him/herself, or said minor, for off-site trips and possibly to and from neighborhoods to camp. The undersigned, or on behalf of said minor, also gives PVC permission to house him/ her, or said minor, during the week of camp and understands that there are no private changing rooms offered in the cabins.
Image Release Waiver
The undersigned also gives permission to PVC to use any photographs and videos and audio of him/her, or said minor, for
promotional materials, including the PVC web site postings, without expectation of compensation, including, but not limited to, any royalties, proceeds, and/or other benefits derived from such photographs, videos, or audio recordings.
Medical Release Waiver
The undersigned also gives permission to the Health Supervisor to provide or arrange necessary transportation and to secure and administer proper treatment as needed and give permission to release any records necessary for insurance purposes. The undersigned also gives permission to PVC to use any of his/her insurance information, or said minor’s, to cover any medical need that may arise.