Agape Adventure Camp Registration
Summer Camp Registrations forms must be completed in full and approved prior to your child attending camp.
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Parent/Guardian Name
Parent/Guardian email  *
Parent/Guardian emergency contact phone:
Parent/Guardian Address *
Participant Name (and what they prefer to be called) *
Participant birthdate
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Does your child have any allergies or special considerations we should be aware of?
Accident and Liability Waiver
I, on behalf of myself or a participant for whom I am signing as a legal guardian below (the minor participant), if applicable, understand that in the course of participating in activities operated by Agape Animal Rescue & Training Center the participant may have direct contact with domesticated animals.
I further understand that the behavior of domesticated animals is sometimes unpredictable and that some domesticated animals are capable of inflicting serious personal injury as well as extensive property damage.  I also understand that there are diseases that can be transmitted between animals and people.  Agape makes no representations or warranties as to any level of training of the domesticated animals or as to the safety of the activities or interaction with domesticated animals.  If I have questions or concerns about such risks, injuries or diseases, I will consult my healthcare provider.  Knowing the risks of handling and being exposed to or otherwise in the presence of domestic animals, I agree to assume those risks and to release, indemnify, and hold harmless Agape Animal Rescue and any of its agents, directors, officers, members, employees, board members, or other volunteer workers for any and all personal injury and property damages resulting from participation. I agree to be supervised by an Agape Animal Rescue staff member or designee and will report to the staff member or designee any problems that arise.
I assume responsibility for all risks of loss or damage or injuries that may be suffered by me or the minor participant, or to the property owned by me or in my custody or any property owned by or in the custody of the minor participant, in the course of Agape Animal Rescue activities from any cause, including but not limited to ordinary negligence attributed or which might be attributed to Agape Animal Rescue or any of its agents, directors, officers, members, employees, board members or other volunteer workers, whether sustained or suffered at the premises under the control of Agape Animal Rescue or at any other premises not under the control of Agape Animal Rescue, or when traveling to or from all such premises by any means of travel, including but not limited to privately owned vehicles, my own automobile or a vehicle borrowed by me, and public transportation.I hereby release, discharge and indemnify Agape Animal Rescue, and all third party entities (such as off-site locations), Agape Animal Rescue agents, directors, officers, members, employees, board members and volunteer workers from and in respect to any and all claims, actions and rights to causes of action, present or future, whether known, anticipated, for any injury, including death, loss of or damage to any property, suffered or sustained from any cause incident to or arising out of, during, or in connection with participation in Agape Animal Rescue activities.*

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Consent to Emergency Response, First Aid and Medical Treatment: In case of emergency, I give permission to the Agape Animal Rescue staff member or designee to administer first aid and give permission to an attending physician to hospitalize or secure proper treatment for myself or the minor participant.  In case of an injury or illness, I give permission to the Agape Animal Rescue staff member or designee to administer first aid for myself or the minor participant.  I understand and acknowledge that Agape Animal Rescue staff are not medical professionals and do not have formalized first aid training.
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By signing this document, I agree that Agape Animal Rescue, its employees, agents, officers, directors, contractors, affiliates, volunteers, and any third parties involved in the creation of Agape Animal Rescue print and electronic publications may use the images and voice at their sole discretion in furtherance of Agape Animal Rescue, and Agape Animal Rescue activities and events.  I hereby grant Agape Animal Rescue all rights in the images and voice, which rights include but are not limited to, copyrights, and the right to receive any and all royalties, proceeds or other benefits (monetary or otherwise) derived from the use of the images and voice. I understand that this document includes my permission for Agape Animal Rescue to freely use the images and voice and that I will receive no financial compensation for such use by Agape Animal Rescue. By signing this document, I agree to release, forever discharge and hold harmless Agape Animal Rescue and its agents, directors, officers, members, employees or other volunteer workers and any third parties involved in the creation of Agape Animal Rescue print and electronic publications from any reasonable expectation of privacy, confidentiality that I might associate with the images and voice; and any and all liability claims, demands, or causes of action of whatever kind, in law or equity, associated with the use of the images and voice in the furtherance of Agape Animal Rescue.
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Photographic, Video & Digital Image and Voice Recording Release and Waiver of Liability: I hereby grant permission to Agape Animal Rescue to use and publish my name or the name of the minor participant, and any and all photographs, video or digital images taken of me or my likeness, or of the minor participant, and any recordings of my voice or the minor participant, that have been made in connection with participation in Agape Animal Rescue activities and events (“the images and voice”), for use in the furtherance of their mission, including but not limited to, for use in any and all print or electronic publications that promote Agape Animal Rescue, and Agape Animal Rescue activities and events.
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Cancellation Waiver
We require cancellation notification at least one (1) week prior to your camp session start date. If we do not receive this notice, a refund will not be given.
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The representations, conditions and commitments contained in this document shall be binding upon my heirs, assigns, next of kin and personal representatives.I acknowledge and represent that I am over the age of 18, have read the entire document, understand the terms and provisions of this document, and that I have signed this document knowingly and voluntarily.  I acknowledge and represent that I am a legal guardian of the minor on behalf of which I am signing and that I am authorized to sign on behalf of the minor at issue.  I understand that this document shall be governed by Tennessee law, and is intended to be as inclusive as Tennessee law permits.   In the event any court of competent jurisdiction finds any provision of this document invalid, I agree that the invalidity of such provision shall not otherwise affect the validity of remaining provisions of this document.
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