2026 YETI Adult Releases

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Participant's Name* This field is required.
First Name
Last Name
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Emergency Contact* This field is required.Please include the information of an individual who will serve as the point of contact in the event of an emergency.
Name
Relationship to the Participant
Phone Number
Email
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Insurance Information* This field is required.
Policy Holder's Name
Policy Holder's Birthdate
Health Insurance Provider (name of the health insurance company i.e. Blue Cross Blue Shield, Anthem, etc)
Policy Number
Group Number
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Photo Release Form: At YETI, we like to take pictures of all of our activities to illustrate and promote future events. Sometimes, we will use these photos for promotion purposes such as brochures, newsletters, flyers, websites, proposals, etc. Your name will never be used in conjunction with any photo. PNWBD, NBDF, HFA, OHSU and GutMonkey request your permission to use photos or videotape of you taken at the YETI conference.* This field is required.
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COVID-19 Safety Agreement: I agree that I will follow all COVID-19 safety protocols required by Pacific Northwest Bleeding Disorders, Camp Collins, GutMonkey, and additional programming partners while in attendance at the YETI Conference. * This field is required.
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Behavior Contract: PNWBD adheres to the highest safety standards and regulations. We maintain the values of caring, honesty, respect and responsibility. Tobacco and Nicotine products, alcohol, recreational cannabis, illegal drugs, weapons, and sexually explicit material and/or behavior are grounds for immediate dismissal from YETI and removal of the individual/family from future participation in PNWBD programming. Negative behavior will not be tolerated during YETI. Although the above steps may be implemented, PNWBD volunteers/staff retain the right to take immediate action if the participant’s behavior poses a threat to their own safety, the safety of others in the program, or any volunteers/staff. I accept the rules and process described above and agree to be on my best behavior while attending the 2026 YETI Conference. I understand that my behavior could have an impact, especially if it is negative behavior, on the future of YETI.* This field is required.
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Liability Release: I certify that I am fully capable of participating in and being a participant of the PNWBD YETI Conference that will be held February 20-23, 2025, at Camp Collins in Gresham, Oregon. Therefore, I assume responsibility for bodily injury, death and loss of personal property and expenses thereof as a result of my negligence while participating in the above-stated activities, except to the extent such damage or injury can be shown to be due negligence of the Pacific Northwest Bleeding Disorders, GutMonkey, and/or Camp Collins. I further understand that Pacific Northwest Bleeding Disorder personnel reserves the right to refuse participation for any person judged to be incapable of meeting the rigors and requirements of participating in this activity. I acknowledge that any bodily injury, death, and loss of personal property that occur in breaks between programming, personal free time during the conference, before the conference begins, or after it wraps up each day is not the responsibility of PNWBD or other YETI Conference partners. PNWBD is not responsible for the actions of participants before arriving at Camp Collins on February 19, 2026, or after the departure from Camp Collins on February 22, 2026. Any actions that result from the participant's own decisions outside of the limits of the YETI Conference programming are not the responsibility of PNWBD or other programming partners. If you have any questions regarding this form, please contact the PNWBD office at (541) 753-0730.* This field is required.
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Medical Release In case of medical and/or surgical emergency, I authorize the YETI program medical staff to provide or to arrange for me to receive any x-ray, anesthetic, medical, dental, surgical procedure, treatment and hospital care which is deemed advisable by and is to be rendered under the supervision of any physician, dentist or surgeon licensed in Oregon.In the event of a medical emergency, I grant permission to be transported or transferred [taken] to a medical facility for treatment and care at the discretion of the YETI medical staff.I will be responsible for all costs incurred for emergency, inpatient or outpatient care. I understand that I will be covered solely by the medical insurance policy in which I am enrolled.I authorize a licensed professional to dispense any medication recommended or prescribed by a physician to me.* This field is required.
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YMCA Camp Collins Agreement YMCA Camp Collins program areas may include, but are not limited to, Challenge Course, Climbing Tower, Aquatics, Horseback Riding, Sports and Games, Archery, Arts and Crafts, Hiking/Nature activities and evening 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 include sitting, walking, running, swimming, wading, jumping, throwing, use of archery equipment (bows and arrows), riding horses, and contact with craft supplies (paint, glue, dye and potentially hot liquids such as wax). When utilizing the Challenge Course activities may also include participating in group initiatives on low (2-3 ft. off of the ground) and high (25-40 ft 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 are able to 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.RELEASE and WAIVER of LIABILITY and HOLD HARMLESS AGREEMENT IN CONSIDERATION FOR BEING PERMITTED TO PARTICIPATE IN YMCA CAMP COLLINS PROGRAMMED ACTIVITIES, I AGREE TO THE FOLLOWING: I hereby accept any and all responsibility for, and assume the risk of any and all injury or damage to my person or dependent children that might arise directly or indirectly as a result of, and or participation in YMCA Camp Collins program areas or activities. I hereby expressly release, discharge and hold harmless from any liability, losses, causes of action, expenses and/or claims for damages whatsoever the YMCA of Columbia-Willamette, the various branches and subdivisions thereof, and all employees and volunteers in their capacities as representatives of the YMCA, expressly including, but not limited to, the Board of Directors of the YMCA of Columbia-Willamette, except for injuries caused intentionally or by willful misconduct by such parties. I certify that I am familiar with the contents of this release, that I have read and understand the same, and that it is my intention by signing this release that the same be binding not only on me, but my heirs, administrators, executors, successors and assigns. I understand the risks involved in participation of outdoor recreational activities, and I am fully aware that there may be hazards and risks unknown to me, and I am physically able to participate in all the program areas listed above. I understand that I am responsible to pay my own medical and emergency expenses in the event of accident or illness regardless of whether I have authorized such expense. Furthermore, I am fully aware that the risks, known and unknown, can cause injury, property damage, illness, mental or emotional trauma, disability or death. This waiver and release will be construed broadly to provide a waiver and release to the maximum extent permissible under applicable law. Any provisions found to be void or unenforceable shall be modified or deleted to the minimum extent necessary to make then enforceable, and shall not effect the enforceability of any other provisions.I HAVE READ THIS AGREEMENT AND RELEASE, I UNDERSTAND IT, AND I SIGN IT VOLUNTARILY* This field is required.
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Synergo Participant Agreement PARTICIPANT AGREEMENT(Including Acknowledgment and Assumption of Risk, Agreements of Release and Indemnity, and Other Provisions)In consideration of the services of Synergo, LLC, a Limited Liability Company organized and existing underthe laws of the State of Oregon ( referred to in this document as “Synergo”) I , Participant and Parent of a minorparticipant, acknowledge and agree, for myself and on behalf of a minor participant for whom I sign, asfollows:Activities and RisksI understand that the challenge course activities conducted by Synergo, the structures and premises onwhich they are conducted and related equipment, may expose participants to certain risks. The activitiesrequire moderate physical exertion, and include a variety of games and initiatives, high and low challengecourse elements (a variety of structures over, through and on which participants may be asked to walk, swingor climb, with or without the assistance of staff or co-participants) and associated challenge course climbingactivities. Certain of the challenge course activities may be conducted as high as 50 feet off the ground.Among the hazards and risks of the activities and use of the premises and equipment are the following:falls; abrupt and possibly harmful contact with structures, objects, and persons; anxieties and fears associatedwith heights; close contact with other participants; carelessness and misjudgments on the part of participantsand the staff of Synergo, including by failing to follow proper procedures, instructions and the operatingpolicies of Synergo; the failure of structures and equipment; and the unpredictable forces of nature.Participants may experience an increased heart rate and other symptoms of anxiety and stress due to physicalexertion, reliance on other participants, and a fear of height or of being unprotected or falling. Injuriesassociated with participation in this program may include breaks, sprains, strains, bruises and other contusionsand in extreme cases, emotional upset, anxiety and even death.I understand that there may be times during the training day in which participants will not besupervised by Synergo, and that Synergo has no responsibility for participant during those times, for thegeneral condition of the premises on which the activities are conducted, nor for any activity on such premisesother than, to the extent provided below, the actual training activities.The description of these risks above is not complete and other unknown or unanticipated risks mayresult in property loss, injury or death. Engaging in these activities may require a degree of skill and knowledgedifferent from other activities with which participants may be familiar. Participants have responsibilities formanaging the risks to themselves and others. The training activities are instructional in nature and participantsare expected to expand and challenge their skills and judgment. Participant and Parent acknowledge thatparticipation in this activity is purely voluntary, and with full knowledge of the inherent and other risks.overAcknowledgment and Assumption of RisksUnderstanding the nature of the activities and their risks, and that other risks may be encountered, Iacknowledge and expressly assume all risks of the Synergo activities, whether or not described in thisdocument, known or unknown and inherent or not. If I am the Parent of a minor participant, I have discussedthe activities and risks with the child, who chooses to participate nevertheless. I take full responsibility for anyinjury or loss, including death, which I, or the minor for whom I sign, may suffer, arising in whole or part out ofmy, or the minor’s, enrollment or participation in the activities of Synergo.Release and IndemnityIf I am an adult Participant or the Parent of a minor Participant, I hereby agree, for myself and on behalf ofthe minor participant for whom I sign below, TO RELEASE AND NOT TO SUE Synergo, its owners, members,directors, managers, officers, agents, employees and volunteers, (“Released Parties”), with respect to any andall claims of injury, disability, death, or other loss or damage to person or property suffered by me or by thechild, arising in whole or part from my or the child’s enrollment or participation in the training or any relatedactivity. In addition, I agree TO INDEMNIFY (that is, defend and satisfy by payment or reimbursement,including costs and attorneys fees) Released Parties from any claim of loss, injury or death, brought by or onbehalf of the child for whom I sign, a co-participant in the activities, a rescuer, a member of my, or the minorchild’s, family, or anyone else, arising out of or in any way related to a loss suffered by me or the child, orcaused by me or the child. These agreements of release and indemnity include loss or damage caused orclaimed to be caused in whole or in part by the negligence of a Released Party, but not intentional wrongs or thegross negligence of a Released Party.Additional ProvisionsI, an adult Participant or Parent of a minor Participant, authorize Synergo to provide or obtain for me, orfor the minor, such medical care as it considers necessary and appropriate, and I agree to pay all costsassociated with such care and related transportation. Synergo and any third party medical care giver areauthorized to exchange medical information concerning my, or the minor’s, medical condition. Any disputebetween a Released Party and Parent or Participant will be governed by the substantive laws of the State ofOregon (not including laws which might apply the laws of another jurisdiction), and any mediation or suit shalltake place only in that state, in Multnomah County. If the dispute cannot be resolved by mutual agreement, Iagree to submit it to a mediator recognized by the Courts of that State and County. I will pay all costs andattorney's fees incurred by any Released Party in defending a claim or suit brought by me, or by or on behalf ofthe minor participant, if the claim or suit is withdrawn or to the extent a court or mediator determines that theReleased Party is not responsible for the claimed injury or loss.I hereby give my permission and consent to the taking of photographs, videotapes, and other images ofme, or the child, and agree that such images may be published and otherwise used by Synergo for advertising,promotion, publicity, or such other purpose as it deems appropriate, without compensation to me or to thechild.This agreement is entered into voluntarily, and after careful consideration. Its terms cannot besupplemented or amended except in writing. I understand and agree that it is binding, to the fullest extentallowed by law, upon all persons signing below, their respective heirs, executors, administrators, wards, minorchildren (whether or not they are Participants) and other family members. If any part of this agreement isfound by a Court or other appropriate authority to be invalid, the remainder of the agreement neverthelessshall be in full force and effect* This field is required.
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GutMonkey Agreement: ACKNOWLEDGEMENT AND ACCEPTANCE OF RISKSParticipating (whether simply attending, observing or actively participating) in GutMonkey educational, instructional, recreational and/or adventure activities include risks. These activities can take place in various locations. Activities which may be led by GutMonkey staff, subcontractors or others include, but may not be limited to: axe throwing, boating (including rafting, canoeing and sea kayaking); fishing; camping; running; hiking; experiential activities including a variety of games and group initiatives; canopy zipline tours as well as low and high challenge courses (systems which include poles, ropes, cables, ziplines, ladders, platforms, swings, climbing towers and other natural and manmade elements, over and on which participants move, with and without assistance from staff or other participants) and related equipment; a combination of training modalities that involve role-playing; socializing; games and activities; use of any equipment, facilities or premises; and transportation in vans, buses or other vehicles (collectively referred to in this Document as “Activities”). Activities may be scheduled or unscheduled, supervised or unsupervised, and include activities undertaken during the participant’s free and/or independent time. I acknowledge that the inherent and other risks, hazards, and dangers (collectively referred to in this Document as “risks”) of the Activities can cause injury, damage, death or other loss to the participant or others. The parent of a minor gives permission for their child to participate in all Activities and agrees to discuss the nature of the Activities and risks with their child. I UNDERSTAND THAT THE RISK INCLUDE, WITHOUT LIMITATION:1. Weather, environmental, and surface and subsurface conditions that are unpredictable and dangerous, including risks associated with lightning, snow or ice accumulation, high altitude conditions, fast moving rivers or other water bodies, falling or fallen timber, rockfall, icefall, steep or slippery terrain, electrical storms, mountain storms, rain, hail, sleet, unstable or loose rock, wild or domestic animals, stinging, venomous and/or disease carrying animals, insects or microorganisms, and other natural and manmade hazards and dangers; 2. Participant’s mental, physical or emotional condition (including use or abuse of alcohol or any prescription or nonprescription drugs), disclosed or undisclosed, known or unknown, combined with participation in the Activities includes risks. Although GutMonkey will review participant’s submitted medical information, GutMonkey cannot anticipate or eliminate risks or complications posed by participant’s mental, physical (including fitness level) or emotional condition; 3. Risks associated with GutMonkey staff decision-making and judgments, which are often based on a variety of perceptions and evaluations, which by their nature are imprecise and subject to error; 4. Risks from participating in a physically exerting activity such as engaging in repetitive arm and leg movements, bending, walking, twisting, pulling, lifting, running, jumping, climbing, and swinging; 5. Risks associated with any outdoor or athletic activity including that a participant may overestimate his or her abilities or fitness; be inattentive; lose control and trip or fall and/or collide with others, the ground, or encounter other hazards; not understand the functioning of (or misuse) the equipment; fail to negotiate steep, uneven or difficult terrain; not control his or her speed or experience equipment malfunction; 6. Risks associated with interactions with, and reliance on, other participants or unknown third parties, including the careless or reckless behavior of other people, the possibility of inadvertent touching, and personal disclosure and/or interaction with co-participants; 7. The unavailability of immediate and quality medical attention or rescue possibilities in an isolated and remote (more than one hour away from medical facilities) backcountry location, including the limited ability to communicate with rescue and medical personnel, and to transport or evacuate a participant from an incident location; 8. Risks associated with high and low challenge course elements and zip-lines which may be as high as 50 feet off the ground, including the possibility of falling a large distance, slipping, rope burns, pinches, jolts, splinters or swaying, colliding with other participants, and experiencing anxieties and fears associated with heights; 9. Risks associated with participants having free and/or independent time before, during and after Activities. At all times, all participants share in the responsibility for their own well being; 10. Risks of camping, including the risk of tending to, being near or cooking over an open fire or gas or propane stove that is subject to a gas explosion, scalding or other burns. Other risks include the risk of contaminated water in natural water sources, and the risk of falling trees and/or branches, floods, harsh and unpredictable weather, wildlife disturbances, and other hazards at a camp site; 11. The risk that equipment, gear, or structures (associated with ropes courses or otherwise) may be misused, may not fit, or may break, fail, or malfunction. This includes participant’s personal equipment, GutMonkey equipment or structures, or other equipment (whether purchased, borrowed, or rented). Participants choosing to bring and use their personal equipment (including any safety gear), assume full responsibility (along with the parent of a minor), for choosing appropriate equipment and for the fit and condition of this equipment. GutMonkey requires use of helmets or other safety gear for some Activities. Safety gear may prevent or lessen injuries in some instances, but it is not a guarantee of safety, and injury can occur even with the use of this gear. These risks can result in participants: falling partway or falling to the ground or into the water; being struck by, colliding with or impacting objects, people, animals or the bottom of a water body; experiencing vehicle collision, capsize or rollover; reacting to high altitudes, weather conditions or increased exertion; becoming lost or disoriented; suffering gastrointestinal complications or allergic reactions or experiencing other problems. These and other circumstances may cause heat or cold-related illnesses or conditions (including hypothermia, hyperthermia, cold water immersion, frostbite, or heat exhaustion/stroke); dehydration; hyponatremia; drowning; high altitude sickness; heart or lung complications; broken bones; paralysis or other permanent disability; mental or emotional trauma; concussions; sunburn or other burns; illnesses (including contracting animal/insect borne or contagious diseases); infections; cuts or wounds or other injury, damage, death or loss. I (participant and/or parent of a minor participant) acknowledge and agree: ● To honestly and accurately complete all GutMonkey registration forms (including medical forms) and obey all rules and other policies; ● To disclose to GutMonkey representatives any mental, physical or emotional conditions or limitations which may affect participant’s ability to participate, and represent that participant is fully capable of participating without harming him or herself or others;● GutMonkey representatives are available should I have further questions about the Activities or the associated risks; ● GutMonkey contracts with individuals or organizations that are independent contractors (not employees or agents of GutMonkey) to provide or conduct some of the services and Activities participants will engage in. GutMonkey does not supervise or control these contractors and is not legally liable or responsible for their conduct; ● The information provided above is not complete, other unknown or unanticipated activities, risks, and outcomes may exist, and GutMonkey cannot assure participant’s safety or eliminate any of these risks; ● If participant is borrowing or renting new or used equipment from GutMonkey, the equipment comes "AS-IS," and GutMonkey disclaims all warranties, express or implied (including any conditions of merchantability or fitness for a particular purpose) regarding the equipment; ● Participant is voluntarily participating with knowledge of the risks. Therefore, participant (and parent of a minor) assumes and accepts full responsibility for the inherent and other risks (known and unknown, described above or otherwise) of the Activities and for any injury, damage, death or other loss suffered by participant (and parent of a minor), resulting from those risks, including the risk of participant’s own negligence or other misconduct. Release and Indemnity AgreementPlease read carefully. This Acknowledgement and Assumption of Risks & Release and Indemnity Agreement contains a surrender of certain legal rights. I (adult participant, or parent for myself and for and on behalf of my participating minor child) agree as follows: 1) To release and agree not to sue GutMonkey, with respect to any and all claims, liabilities, suits or expenses (including attorneys’ fees and costs) for any injury, damage, death or other loss in any way connected with my/my child’s enrollment or participation in the Activities (hereafter collectively “claim” or “claim/s”). I understand I agree here to waive all claim/s I or my child may have against GutMonkey, legally bind my/my child’s estate and any family member, heir, or other party bringing claim/s and agree that neither I, my child, nor anyone acting on my or my child's behalf, will make a claim against GutMonkey as a result of any injury, damage, death or other loss suffered by me or my child; 2) To defend and indemnify (“indemnify” meaning protect by reimbursement or payment) GutMonkey with respect to any and all claim/s brought by or on behalf of me, my participating child, spouse or other family member/s, my/my participating child’s heirs or estate, or a co-participant or any other person, for any injury, damage, death or other loss in any way connected with my/my child’s enrollment or participation in the Activities. This includes any and all claim/s which may be presented by a medical care provider, insurer, or other third party as a result of medical care provided to the participant before, during, or after the Activities, including transportation and evacuation costs. This Release and Indemnity Agreement includes claim/s of or resulting from GutMonkey’s negligence (but not its gross negligence or willful or wanton misconduct), and includes claim/s for personal injury or wrongful death (including claim/s related to emergency, medical, drug and/or health issues, response, assessment, or treatment), property damage, loss of consortium, breach of contract, or any other claim. Other Provisions I (participant and/or parent of a minor participant) acknowledge and agree: I understand that GutMonkey reserves the right to dismiss the participant from a course if it believes, in its sole discretion, the participant presents a safety concern or medical risk, is disruptive, or otherwise conducts him or herself in a manner detrimental to the program OR the participant presents a safety, behavioral, medical or other concern. If the participant is dismissed or departs for any reason, I am solely responsible for all costs of early departure (including, but not limited to, travel expenses) whether for medical reasons, dismissal, personal emergencies, or otherwise. I authorize GutMonkey and/or its agents, to photograph, film, record and/or otherwise capture the name, image, voice, written statement, photograph and/or visual likeness of me, my child and/or my other family members (collectively “images”), without compensation, for use in any media throughout the world in perpetuity, including for sale, reproduction or display on the internet, in publications and/or for any informational, promotional or other use. These images are the sole property of GutMonkey and I waive any inspection or approval rights;I authorize GutMonkey staff or other medical personnel to obtain or provide medical care for me/my child, to transport me/my child to a medical facility, and/or to provide treatment they consider necessary for my/my child's health. I agree to the release (to or by GutMonkey) of any records necessary for treatment, referral, billing or insurance purposes. I agree to pay all costs associated with any medical care and/or transportation, including medical and/or airlift evacuation and associated expenses. I agree that Oregon substantive law (without regard to its “conflict of laws” rules) exclusively governs this Document, any dispute I/my child have with GutMonkey, and all other aspects of my/my child’s relationship with GutMonkey, contractual or otherwise. I also agree that any legal proceeding must be filed only in the state or federal court located in the County of Multnomah, Oregon, which will be the sole jurisdiction and venue for any legal proceeding relating to or arising out of the Activities, this Document or otherwise. Before filing a lawsuit, I agree to first attempt to settle any dispute (not settled by discussion) through mediation before a mutually acceptable Oregon mediator. This Document is intended to be interpreted and enforced to the fullest extent allowed by law. If a court or any other appropriate authority finds any portion of this Document to be invalid, all other portions of this Document will remain in full force and effect and binding upon the parties. Participant and/or parent of a minor participant agree: I have carefully read, understand and voluntarily sign this Document and acknowledge that it shall be effective and legally binding upon me, my spouse, participating child and other children, and participant’s/parent’s other family members, heirs, executors, representatives, subrogees, assigns and estate. The participant must sign below. If participant is a minor (those under 18 years of age), one of the participant’s parents or legal guardians must also sign below. I understand that my signature is valid and legally binding whether I choose to electronically sign, or sign a printable version of this Document. I HAVE CAREFULLY READ, VOLUNTARILY SIGN, AND CLEARLY UNDERSTAND THIS DOCUMENT AND AGREE TO BE LEGALLY BOUND BY IT AS STATED ABOVE. ALL PARTICIPANTS 12 YEARS OF AGE OR OLDER MUST SIGN BELOW. * This field is required.
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