Release of Claims

In consideration for being accepted by Free Chapel Worship Center for participation in Camp FCY event, we (I), being 21 years of age or older do for ourselves (myself, for, and on behalf of my child(ren) – participant) if said child is not 21 years of age or older, do hereby release, forever discharge, and agree to hold harmless FREE CHAPEL WORSHIP CENTER and the directors thereof from any liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the child – participant that occurred while said child is participating in the above-described activity. Further, we (I) and on behalf of our (my) child participant, if under the age of 21 years, hereby assume all risk of personal injury, sickness, death, damage, and expense as a result of participation in recreation and work activities involved therein. Furthermore, authorization and permission are hereby given to the said church to furnish any necessary transportation or food for this participant. The undersigned further hereby agree to hold harmless and indemnify said church, directors, camp directors, volunteers, camp employees, church employees, and agents for any liability sustained by such church as the result of the negligent, willful, or intentional acts of the said participant including expenses incurred attendant thereto. ALL SALES ARE FINAL. BOTH FULL PAYMENT AND DEPOSIT ARE NON-REFUNDABLE. The final payment is due on August 22th, 2025.

GUEST CONSENT RELEASE FORM FOR OUTSIDE GROUPS USING YOUNG LIFE CAMP

INDEMNITY AND CONTRACT AGREEMENT: I will not hold or attempt to hold Young Life liable for any loss, damage or injury to person or property caused by any act or neglect of other persons on or about the Property, or caused in any manner other than the willful or grossly negligent act of Young Life, its agents and employees, and will indemnify and hold Young Life harmless from any liability for damages or claims against Young Life arising out of or in any way related to any such loss, damage or injury.

I release Young Life, including its trustees, employees and agents, from my physical injury, including death, or illness while at the Property. I will assume the risk associated therewith, whether known or unknown to me at this time. This release is also intended to include all claims of my family, estate, heirs, personal representatives or assigns.

AUTHORIZATION FOR TREATMENT: I hereby give permission to the medical personnel selected by the camp director to secure and administer treatment and to maintain and/or release any medical records necessary for insurance purposes as outlined under the HIPAA regulation, and to provide or arrange necessary related transportation for the above named person.

To obtain a copy of Young Life’s Notice of Privacy Practices, log on to www.younglife.org or call (719) 867-3600.

I verify that I am or my child is in good health and am capable of participating in strenuous activities, and when necessary, will tailor my activities to those within the bounds of my physical health. I recognize that any medical treatment and/or medical transportation that is provided to me or my child while attending a Young Life camp will be paid for by my medical insurance company.

COVID-19: I recognize that a national emergency was declared because of the COVID-19 outbreak and that different states and/or counties/cities may be in various states of emergency. I recognize that even if Young Life has taken reasonable actions in light of COVID-19 and other coronaviruses, there is no guarantee that me or my child will not contract/transmit COVID-19 or other infectious or contagious illnesses or diseases while participating in activities and events at the Young Life property/camp, or traveling to and from, Young Life’s camp property and I release Young Life in the event of such an occurrence. The Center for Disease Control ( CDC) has identified that certain individuals are at Higher Risk for Severe Illness if they become ill with COVID-19. This includes those who have chronic lung disease, moderate/severe asthma, a serious heart condition, are immunocompromised, or have severe obesity, diabetes, or chronic kidney/liver disease or who are over the age of 65. Based on the CDC’s High-Risk criteria, you have determined if you want to participate in this event or if you want your child to participate in this event.

Camp FCY 2025