I {name} understand and agree that the 2023 Student Mission Retreat on August 11-13, held at Kulaqua Retreat and Conference Center and hosted by St. Paul’s Outreach, Inc. of which I am a participant, involves certain risks and that, regardless of the precautions taken by the above organization, some bodily injury may occur.
Specific risks/hazards involved in the above event include, but are not limited to the following: Driving to and from the retreat, injuries that occur during activities, and possible allergic reactions to food or insect bites.
Knowing this information, in consideration of my participation in the above event, I expressly and knowingly release St. Paul’s Outreach, Inc., Kulaqua Retreat and Conference Center, the Catholic Student Union, Catholic Campus Ministry, the Diocese of Pensacola-Tallahassee, the Diocese of St. Petersburg, the Diocese of St. Augustine, and the Diocese of Orlando and their officers, agents, representatives, advisors, directors, family members, volunteers, helpers, partners, organizational members, associates, and employees from any and all claims and causes of action for property damage, personal injury, or death sustained by me arising out of any travel or activity conducted by or under the auspices of the above organizations caused by risk associated by this activity and /or the negligence of the sponsoring groups.
In addition, I understand and agree that St. Paul’s Outreach, Inc., Kulaqua Retreat and Conference Center, the Catholic Student Union, Catholic Campus Ministry, the Diocese of Pensacola-Tallahassee, the Diocese of St. Petersburg, the Diocese of St. Augustine, and the Diocese of Orlando cannot be expected to control all of the risks articulated in this form, but may need to respond to accidents and potential emergency situations. Therefore, I hereby give my consent for any medical treatment that may be required during my participation with the understanding that the cost of any such treatment will be my responsibility. St. Paul’s Outreach, Inc., Kulaqua Retreat and Conference Center, the Catholic Student Union, Catholic Campus Ministry, the Diocese of Pensacola-Tallahassee, the Diocese of St. Petersburg, the Diocese of St. Augustine, and the Diocese of Orlando do not carry any sort of medical or accident insurance for the activities mentioned, unless the participants are informed otherwise. As such, participants should review their personal insurance portfolio.
Finally, I voluntarily and knowingly agree to defend, protect, hold harmless, and fully indemnify, St. Paul’s Outreach, Inc., Kulaqua Retreat and Conference Center, the Catholic Student Union, Catholic Campus Ministry, the Diocese of Pensacola-Tallahassee, the Diocese of St. Petersburg, the Diocese of St. Augustine, and the Diocese of Orlando and their officers, agents, representatives, advisors, directors, family members, volunteers, helpers, partners, organizational members, associates, and employees against all claims, demands, or causes of action for property damage, personal injury, or death, arising from the negligence or fault of the above named, including defense costs and attorney fees arising out of my participation in the above event of the above organization.
Additionally, I agree to defend, protect, hold harmless and fully indemnify St. Paul’s Outreach, Inc., Kulaqua Retreat and Conference Center, the Catholic Student Union, Catholic Campus Ministry, the Diocese of Pensacola-Tallahassee, the Diocese of St. Petersburg, the Diocese of St. Augustine, and the Diocese of Orlando for any claim or cause of action whatsoever arising out of the 2023 Student Mission Retreat which takes place during the above identified dates of August 11-13, that is brought against St. Paul’s Outreach, Inc., Kulaqua Retreat and Conference Center, the Catholic Student Union, Catholic Campus Ministry, the Diocese of Pensacola-Tallahassee, the Diocese of St. Petersburg, the Diocese of St. Augustine, and/or the Diocese of Orlando by me and/or a family member whether such claim arises from the alleged negligence of St. Paul’s Outreach, Inc., Kulaqua Retreat and Conference Center, the Catholic Student Union, Catholic Campus Ministry, the Diocese of Pensacola-Tallahassee, the Diocese of St. Petersburg, the Diocese of St. Augustine, and the Diocese of Orlando, their employees or agents, or my negligence. If any portion of this agreement is held invalid, it is agreed that the balance thereof, shall continue in full legal force and effect.
I understand that this is a substance-free retreat and agree not to bring and/or consume alcohol and/or any form of illegal substance during this retreat. I have read the above agreement and have willingly signed the same for the consideration expressed and with a full understanding of its purpose. Participant represents that he/she is eighteen (18) years of age or older and is otherwise competent to execute this agreement, or that his/her legal guardian is also signing this agreement.