IDENTIFICATION AND ACKNOWLEDGEMENT
OF RISKS
I understand that Vista Christian Retreat, Inc, ( DBA Camp Vista) (CV) offers activities such
as, but not limited to, swimming, soccer, basketball, volleyball fishing, using air guns, horseback riding, rock climbing, wilderness
travel, ropes course
activities, lake/river activities, skiing, climbing walls, biking,
backpacking, hiking, airplane rides, transportation to and from the activity
site, and many others may result in
property damage or fatal injury. Dangers also inherent
to lakes & rivers, forces of nature
such as darkness, heavy rain, lightning, strong winds, extremes of heat
and cold, biting insects and animals
may cause an accident
or
serious injury. I understand that although Camp Vista has taken reasonable precautions to provide
proper equipment, suitable
facilities, and trained staff, it is impossible to
guarantee totally negligence free environment, absolute safety
against illness, injury, or loss resulting from participation. I voluntarily agree to assume all of
the
foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death),
illness, damage, loss, claim, liability, or expense,
of any kind, that I or child(ren) may experience or incur in connection with my child(ren)’s attendance at CV or participation in CV program.
COVID-19 ACKNOWLEDGEMENT OF RISKS
The novel coronavirus, COVID-19, is contagious. Camp Vista cannot guarantee that you or your family members
will not become infected with COVID-19. Further,
attending any program at Camp Vista could increase your risk and your child(ren)’s risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19,
and voluntarily assume the risk that my child(ren) and/or I may be exposed to
or
infected by COVID-19
by
attending CV, and that such exposure
or infection may result in personal injury, illness, permanent
disability, and death. I understand that the risk of becoming exposed
to or infected
by COVID-19 at CV may result from the actions, omissions, or negligence of others,
including, but not limited to, CV
employees, volunteers and program participants and their families.
ASSUMPTION OF PERSONAL RESPONSIBILITY
I
certify, that participant have no communicable diseases. I will notify Camp Vista and/or grpup in writing of any medical or emotional condition that may restrict
safe participation in the program. I acknowledge that participant failure to adhere to safety rules established by Camp Vista Staff may result in being asked to discontinue
participation in the program.
If participant is
barred from further participation, or if I and/or
participant voluntarily refrain
from participation, or if
I and/or participant leave the trip, I am responsible for all expenses incurred and I have no claim
for any refunds from Camp
Vista and its representatives.
AUTHORIZATION FOR
MEDICAL TREATMENT
In
case of an emergency,
I hereby give permission
to Camp Vista representatives and/or group leaders
of organization who organize the event to secure medical
treatment that might
include hospitalization, to release any records necessary
for insurance purposes, and to
provide or arrange
necessary related transportation for participant named above. I also certify
that my insurance company
or myself will cover all accidental, medical and transportation costs.
CONSENT WAIVER AND RELEASE
In
consideration of participating
in
any activities in any event organized by Camp Vista, I herby agree to release and discharge from liability Camp Vista and its owners, directors, officers, employees, agents,
volunteers, participants, and all other persons or entities acting for them on behalf
of myself and my children,
parents, heirs, assigns,
personal representative and estate. Consequently, I waive, release, and discharge
any and all claims for any personal
injury or damages, death, or property
damage/loss, which I may have
as
a result of participation. I understand
that Camp Vista shall not be
liable for any delay or accidents of means of ransportation arranged
by Camp Vista, any and all acts of a third parties,
or any other cases beyond their control.
Camp Vista reserves
the right to cancel, change, or substitute any service because of weather, safety condition of activity places/equipment, insufficient number of participants or other reasons. My registration provides Camp Vista the authorization to use photos
and videos of me or registered participants for promotional purposes without further consent
or compensation.
INSURANCE
I
am aware, that I am responsible for paying all participant's
medical expenses and related costs
for any injuries
that may occur during participation in the event. I agree to maintain throughout my participation, sufficient medical and accidental insurance (insurance should be valid in the State
of Wisconsin). I understand that this is my sole responsibility
to release CV from providing medical/accidental insurance coverage for
participant.
Camp Vista strongly recommend to purchase a TRAVEL INSURANCE or other insurance to protect against the risk of medical expenses, death, travel delays,
trip cancellation, any damage, loss of baggage or personal elongings, etc.