Consent Form for Arvada Covenant Kids Camp Waiver and Release from Liability
I acknowledge that my child’s participation in the Arvada Covenant Kids’ Camp is voluntary and may involve risks and require involvement in activities that require physical exertion. Such activities may include, but are not limited to: athletic games, off-site excursions, group activities and team events. I (We) acknowledge that my (our) child’s participation in any Kids’ Camp activity presents risks such that my child may suffer property damage, bodily injury, or death. Therefore, in consideration of my child’s participation in the Arvada Covenant Church youth program activities, I (We) agree to the following:
Arvada Covenant Church is not responsible for personal belongings.
I consent to have photographs taken of my child during Kids’ Camp. The pictures may be used on the Arvada Covenant Church web page, in future brochures, or in slide shows after the event.
Inappropriate conduct by my child will result in immediate expulsion from the program. If this occurs I agree to make arrangements for my child to be immediately picked up from Arvada Covenant Church.
I hereby take the following action for child, myself, my executors, administrators, heirs, next of kin, successors and assigns: a) I WAIVE, RELEASE AND DISCHARGE from any and all claims or liabilities for death or personal injury damages of any kind, which arise out of or relate to my child’s participation in Arvada Covenant Church activities, the following person or entities: Arvada Covenant Church, its Senior Pastor, Associate Pastor, Program Staff, Boards, employees, volunteers, representatives, subcontractors and agents of any of the above; b) I AGREE NOT TO SUE any of the persons or entities mentioned above for any of the claims or liabilities that I have waived, released or discharged herein; and c) I AGREE TO INDEMNIFY AND HOLD HARMLESS the person or entities mentioned above in (a) from any claims made or liabilities assessed against them as a result of my child’s actions whether arising from the negligence of the parties mentioned (in (a)) above, or otherwise. I hereby assume the risks of my child participating in all Arvada Covenant Kids Camp activities.
The undersigned (parent/guardian),
the parent and natural guardian or legal guardian of the above listed minor children, hereby executes the foregoing Assumption of the Risk, Waiver, Release and Discharge, Agreement Not To Sue, and Indemnification and agreement to Hold Harmless, for and on behalf of the minor named herein. I agree to indemnify and hold harmless the persons or entities mentioned above for any claims or liabilities assessed against them as a result of any insufficiency of my legal capacity or authority to act for and on behalf of the minor in the execution of the Waiver and Release.
I hereby authorize any licensed physician, emergency medical technician, hospital or other medical or health care facility to treat the minor named herein for the purpose of attempting to treat or relieve any injury received by said minor. I authorize any such Medical Provider to perform all procedures deemed medically advisable in attempting to treat or relieve any such injuries. I consent to the administration of anesthesia as deemed advisable. I realize and appreciate that there is a possibility of complications and unforeseen consequences in any medical treatment, and I assume any such risk for and on behalf of myself and said minor. I further agree to pay all charges for the dental, medical, or hospital care or treatment rendered to my child.
Parent/Guardian Signature
Date
By typing my name here, I acknowledge that this "digital signature" acts just the same as an actual signature and the signee will be held liable to the above terms and conditions.
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Arvada, CO 80002 
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