Please read before submitting*

In consideration of my family’s participation, I agree to indemnify Collective Souls Incorporated, Associates, Facility Owners, Sponsors and Volunteers from any claims or lawsuits brought against Collective Souls Incorporated, by myself, my child, or others who may be attending this event with me, that arises out of any behavior or injuries by us during this event. Participant's and participant’s parent or guardian, (if participant is a minor) agree that this agreement and release of liability is a contract that when submitted by the participant’s parent or guardian involved will be legally binding to all parties and shall be enforced and interpreted under the laws of the state of Missouri. I also understand that we are participating in this event under our own discretion and solely responsible for any medical attention or medical equipment for us due to any injuries. I hereby grant permission to Collective Souls, Inc., representatives to take and use photos, images including testimonies of our participation for use in news release and/or educational materials, marketing, or web site. We authorize the use of these images without compensation to myself, my child, or others who may be attending this event with us. 

Please note if there should be any uncooperative behavior, cause harm to self or others and disrespectful to program leaders, volunteers, or sponsors, you will be asked to this event.

Family contact please type your name below showing that you have read and agree to the above information.