2023 WOLY Camp Registration Name * First Name Last Name Date of Birth * MM DD YYYY Age * Gender * Male Female Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email Camp fee * Select how many days you will attend $120 for 5 days $80 for 3 days $30 for 1 day Are you a member of Word of Life Church? * Yes No If no, what church do you attend? Adult T-Shirt Size (Select One): * XS S M L XL 2XL Any Allergies, Medications, or Medical Conditions? * Yes No If yes, please explain: Insurance and Policy Number: * Emergency Contact Name: * Emergency Contact Phone: * (###) ### #### Relationship to Registrant: * By signing below, I acknowledge and confirm that all the information provided by me in my camp application is true, complete, and accurate to the best of my knowledge. I understand that any falsification or omission of information will result in the immediate termination of my participation in the camp program. By signing below, I acknowledge and agree to abide by all the rules, regulations, and policies included on the next page that have been set by Word of Life and Covenant Park Bible Camp. I understand that failure to comply with these rules may result in disciplinary action, up to and including expulsion from the camp program without refund * I acknowledge CAMP WAIVER AND RELEASE OF LIABILITY FORM * I acknowledge that I am voluntarily participating in Word of Life Youth Camp, which is being held at Covenant Park Bible Camp from July 23, 2023, to July 29, 2023. In consideration of being allowed to participate in this Camp, I agree to the following: 1. Assumption of Risk: I understand and acknowledge that my participation in the camp program involves inherent risks, including but not limited to, hysical activity, contact with other participants, and outdoor activities that may result in injury or death. 2. Medical Authorization: I hereby authorize the camp staff to obtain any and all medical treatment for me in the event of an emergency, including but not limited to medication, syringes, cardiopulmonary resuscitation, or transportation to Hospital. I agree to assume all costs associated with all treatment. 3. Release of Liability: I hereby release and forever discharge Word of Life Church and Covenant Park Bible Camp, its owners, officers, agents, employees, and volunteers (collectively, the “Released Parties”) from any and all claims, demands, damages, or causes of action arising from or in connection with my participation in the camp program, including but not limited to, any injury or death caused by the negligence of the Released Parties. 4. Indemnification: I agree to indemnify and hold harmless the Released Parties from any and all claims, demands, damages, or causes of action brought against them by any third party arising from or in connection with my participation in the camp program. 5. Photo and Video Release: I hereby grant permission to the Word of Life Church and Covenant Park Bible Camp to use any photographs, videos, or other recordings of me taken during the camp program for future promotional purposes. 6. Governing Law: This agreement shall be governed by and construed in accordance with the laws of the state of Minnesota, where the camp program is located. 7. Severability: If any provision of this agreement is found to be invalid or unenforceable, the remaining provisions shall remain in full force and effect. I have read this waiver and release of liability form, and I understand its contents. I acknowledge that I am signing this agreement freely and voluntarily, and that no representations or warranties have been made to me to induce me to sign this agreement. I acknowledge that my signature is legally binding. First Name Last Name Participant's Signature: * Typing in a name constitutes as a signature. First Name Last Name Today's Date * MM DD YYYY Participant’s Date of Birth: * MM DD YYYY Are you (camp participant) over the age of 18? * Yes: Scroll to bottom of form to submit No: Complete CAMP WAIVER AND RELEASE OF LIABILITY FORM FOR MINORS section before submitting CAMP WAIVER AND RELEASE OF LIABILITY FORM FOR MINORS I, as the parent or legal guardian, acknowledge that my child, who is under the age of 18, is voluntarily participating in Word of Life Camp, which is being held at Covenant Park Bible Camp from July 23, 2023, to July 29, 2023. In consideration of my child being allowed to participate in this program, I agree to the following: 1. Assumption of Risk: I understand and acknowledge that my child’s participation in the camp program involves inherent risks, including but not limited to, physical activity, contact with other participants, and outdoor activities that may result in injury or death. 2. Medical Authorization: I hereby authorize the camp staff to obtain any and all necessary medical treatment for my child in the event of an emergency, including but not limited to medications, syringes, cardiopulmonary resuscitation, or transportation to Hospital. I agree to assume all costs associated with any such treatment. 3. Release of Liability: I, on behalf of myself and my child, hereby release and forever Word of Life Church and Covenant Park Bible Camp, its owners, officers, agents, employees, and volunteers (collectively, the “Released Parties”) from any and all claims, demands, damages, or causes of action arising from or in connection with my child’s participation in the camp program, including but not limited to, any injury or death caused by the negligence of the Released Parties. 4. Indemnification: I agree to indemnify and hold harmless the Released Parties from any and all claims, demands, damages, or causes of action brought against them by any third party arising from or in connection with my child’s participation in the camp program. 5. Photo and Video Release: I hereby grant permission to Word of Life Church and Covenant Park Bible Camp to use any photographs, videos, or other recordings of my child taken during the camp program for any future promotional purposes. 6. Governing Law: This agreement shall be governed by and construed in accordance with the laws of the state of Minnesota, where the camp program is located. 7. Severability: If any provision of this agreement is found to be invalid or unenforceable, the remaining provisions shall remain in full force and effect. 8. Parent/Legal Guardian’s Acknowledgment: I acknowledge that I have read this waiver and release of liability form, and I understand its contents. I acknowledge that I am signing this agreement freely and voluntarily on behalf of myself and my child, and that no representations or warranties have been made to me to induce me to sign this agreement. 9. Acceptance of Responsibility: I understand that Word of Life Church and Covenant Park Bible Camp will take reasonable steps to ensure the safety of my child, but I acknowledge that I am ultimately responsible for my child’s well-being during the duration of the camp program. I have read this waiver and release of liability form, and I understand its contents. I acknowledge that I am signing this agreement freely and voluntarily, and that no representations or warranties have been made to me or my child to induce me to sign this agreement. I acknowledge that my signature is legally binding First Name Last Name Participant's Signature: Typing in a name constitutes as a signature. First Name Last Name Today's Date MM DD YYYY Parent/Legal Guardian’s Full Name: First Name Last Name Parent/Legal Guardian’s Signature: Typing in a name constitutes as a signature. First Name Last Name Today's Date MM DD YYYY Please note, if the participant is under 18 before July 23, 2023, a parent or legal guardian must sign “Camp Waiver and Release of Liability Form for Minors” before turning the forum(s) in. * I am over 18 My Parent/Legal Guardian has signed the release form Thank you!