Parent/Guardian Info

The church you attend. (Also include the church you are coming with if different.)

Camper Info

Grade refers to grade completed at time of camp
Grade completed at camp time
If registering before March 15th
Only one request. Your request must request you.

Liability Waiver and Release Agreement

In consideration of Peniel Bible Camp, its directors, officers, representatives, employees, and volunteers (hereafter known as PBC) allowing the individual named below (hereafter known as Participant) to participate in any camp program or use the camp property and/or facilities, and having read and understood this agreement, the Participant (or parent/guardian if Participant is a minor) agrees to the following:

Acknowledgement of risk: I acknowledge and agree that participation in any activity at Peniel Bible Camp comes with inherent risks including, but not limited to, sickness, exposure to infectious/communicable disease, bodily injury, death, emotional injury, property damage, and financial loss.

Waiver of Liability: I understand that PBC assumes no responsibility for any injury or loss to Participant sustained during camp activities or while on camp property; Participant will not attempt to hold PBC liable for any injury or loss sustained during activities or while on property; and Participant releases, waives, discharges, and covenants not to sue PBC from any liability or claim related to any injury or loss resulting from use of facilities or equipment or participating in any program, regardless of how the injury or damage occurs. Furthermore, Participant releases and promises to indemnify, defend, and hold harmless PBC from and against any claims and all other losses or damages arising directly or indirectly from such participation, whether such injury, loss, or damage arises out of negligence of PBC, Participant, or any third party.

Assumption of risk: I understand that, by participating in any camp program or using the property/facilities, Participant assumes the risk known and unknown of injury and loss that are inherent in camp activities and by use of camp property. Participant thereby voluntarily attends and participates.

Consent for medical treatment: I grant permission for PBC to transport Participant to licensed physician or medical facility for necessary medical treatment or attention authorized by PBC if PBC cannot contact the listed emergency contact. Participant gives consent to said physician or facility to provide treatment deemed necessary to relieve pain or preserve life or health of the participant. Participant further authorizes PBC to provide first aid, CPR, or other treatment by a qualified staff member when deemed necessary and authorized by PBC.

Acceptance of effect: I understand and agree that this agreement is binding on Participant, his/her heirs, estates, and legal representatives. If a dispute over this agreement arises, Participant agrees to resolve the matter through a mutually acceptable alternative dispute resolution process.

Use of image/likeness: I grant PBC the absolute right to copyright, reuse, publish and republish by any medium, including print and electronic, any photo, image, likeness, or recording in which Participant might be included for any purpose including, but not limited to, promotion and marketing. Participant also waives any right to inspect or review final products and waives any claim for compensation from the use or publication of these items.

I hereby acknowledge that I have fully read and understand each of the above provisions and fully consent to the Liability Waiver and Release Agreement as stated. By typing my name below and submitting this form, I voluntarily agree to its terms and affirm that my electronic signature is legally binding and has the same force and effect as a handwritten signature.