OFFICAL CAMPER/VOLUNTEER WAIVER FORM

Location: Dub Patton & Pavilion 761, Arkabutla Lake, DeSoto SWCD, or Eudora Fire Department

This is a waiver. Please read it carefully before signing. The undersigned has read this waiver and hereby agrees:

• To waive all claims arising out of or in any way related to this camp.
• To waive all claims against individual volunteers, project coordinators, sponsors, suppliers, supporters, landowners, DeSoto County Soil & Water Conservation District, USACE(United States Army Corps of Engineers), Eudora Fire Department, DeSoto County, or other organizations affiliated, their employees and agents.
• To assume and accept responsibility for all risks or accidents arising from or relating to this camp.
• Participation in this activity is completely voluntary and that I have neither received payment nor expect to receive any compensation for my participation.
• To read, listen to, and follow all safety instructions presented in conjunction with this camp.
• To use good judgment based on physical ability and to immediately terminate participation in the project if activities become too strenuous or difficult.
• Represents that s/he is physically and mentally fit and able to participate in this camp.
• That this waiver shall act as a complete bar against all actions or claims, including negligence claims, arising from or related to this camp; that if any action or claim is made, this waiver shall warrant immediate and final dismissal of all such actions or claims; that this waiver applies to all claims made by myself or my legal hers, representatives, or agents.

I also agree and understand that photographs and/or videos, which include my camper's image, taken at the Program may be used in DeSoto County Soil & Water Conservation District, USACE, Eudora Fire Department, or any other participating agency publications for advertising, publicity, and commercial or other business purposes. I hereby give DeSoto County Soil & Water Conservation District and all participating agencies or volunteers permission to duplicate and distribute the photographs, or any parts thereof which include my camper image, in perpetuity in any manner and in any and all media, including the Internet, whether known now or hereafter devised. I waive any right to inspect or approve the finished version(s).

If not completed below, your camper will be deemed ineligible to participate in Conservation Kids Camp and registration will be voided.

Please list all of the following in the space provided below to confirm you understand and agree with said waiver.

This information must be listed below:

Camper Name

Address

City, State, Zip

Phone

Parent/Guardian Name

Parent/Guardian Initials

DATE