CAMP PARTICIPATION AUTHORIZATION AND RELEASE
I hereby request that Creation Station permit my child identified above to participate in the above referenced services or activities. I am aware that there are certain risks associated with such participation. I, individually and on behalf of my minor child, hereby knowingly and voluntarily assume any and all such risks. Moreover, for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, I, individually and on behalf of my minor child, agree to indemnify and knowingly and voluntarily release, acquit, and discharge Creation Station, and each of its officers, directors, employees, agents, volunteers, and representatives, of and from any and all liability, losses (known or unknown), damages, costs, claims, demands, causes of action and/or expenses, including attorneys' fees, relating to or arising from such participation, including but not limited to personal injury, property damage or wrongful death, unless such claims result from the willful misconduct or gross negligence on the part of Creation Station. I further authorize Creation Station personnel, as agent for the undersigned, to consent on behalf of my child to any medical treatment (including but not limited to any x-ray, examination, anesthetic, medical or surgical diagnosis or treatment and hospital care) which is deemed advisable by the physician, nurse or other health care practitioner present at or in connection with the above referenced service.
USE OF CAMPER INFORMATION
By checking the box and typing my full name below, I grant permission for Creation Station to reproduce through printed, audio, visual, or electronic means activities in which my child has participated in at the above-referenced camp. I, as a parent or guardian, of the above named child, fully authorize and grant Creation Station and its authorized representatives, the right to print, photograph, record, and edit as desired the biographical information, name, image, likeness, and/or voice of the above named camper on audio, video, film, slide, or any other electronic and printed formats. We, the undersigned, hereby authorize Creation Station to use our camper's name, photograph, and other information in Creation Station publications and on the Creation Station website.
BY CHECKING THE BOX AND ADDING MY ELECTRONIC SIGNATURE BELOW, I AM AGREEING THAT I HAVE READ THE ABOVE CAMP PARTICIPATION AUTHORIZATION AND RELEASE AND FULLY UNDERSTAND ITS TERMS. CHECKING THE BOX AND ADDING MY ELECTRONIC SIGNATURE BELOW IS VOLUNTARY AND INDICATES THAT I ACCEPT ALL TERMS OUTLINED IN THIS AGREEMENT.