I, as the burn survivor/parent guardian, understand that I must be present for the ENTIRE weekend and am limited to bringing individuals outlined on the first page of this registration. If I, the burn survivor, am unable to participate in the Getaway weekend, my group is NO longer eligible to attend.

· I, as the burn survivor/parent guardian, agree to participate with my group in ALL ACTIVITIES throughout the Getaway weekend. If I decide not to participate in these planned activities, I understand that I will not be eligible to participate in the Getaway in the future.

· I, as the burn survivor/parent /guardian, agree to be responsible for my child and/ children in my party during the entire weekend.

· While participating in this event, as the burn survivor/parent /guardian, understand that unacceptable behavior, firearms, or ANY use of drugs or alcohol can result in dismissal. I will take responsibility for the actions of the others listed as a part of my group. I understand that if any damages occur to the camp property caused by the inappropriate actions of myself or my group, I may be held liable for the costs incurred and can result in dismissal.

· I understand that Camp Oakhurst has a no pet policy, and I am restricted from bringing any animal (s) to camp.

· I, as the burn survivor/parent guardian, understand outdoor activities are hazardous sports that can result in serious injury, death or other damage. I accept responsibilities for my group to be informed about all outdoor activities and participate in such activities safely and to follow established safety guidelines. I hereby release and hold harmless the Alisa Ann Ruch Burn Foundation.

I, as the burn survivor/parent/ guardian, understand that the insurance held by the Alisa Ann Ruch Burn Foundation is secondary and is supplemental to my own health insurance. If I chose not include medical insurance information on this application, I hold myself responsible for payment of all medical procedures and hospitalization for myself and my group. I understand that the Alisa Ann Ruch Burn Foundation or Camp Oakhurst may not be able to accommodate all medical needs- such as third trimester pregnancy and some forms of disabilities.

· By signing this agreement, I, as the burn survivor/parent /guardian, am committing to attend The Getaway Family Camp 2022. I have read and understand the above statements and that all information herein is true. Registration without payment will NOT be processed. If for some reason I am unable to attend, or if there are changes to my registration, it is my responsibility to contact the Alisa Ann Ruch Burn Foundation by Friday, August 26, 2022. I also understand that I will not be able to receive any reimbursement of fees for not attending.

Please agree by E-signing and dating below: