Activity Waiver and Release Form CompanyThis field is for validation purposes and should be left unchanged.This field is hidden when viewing the formFMCodeActivity(Required)Select which activity this participation agreement will cover. Horsemanship Climbing Paintball Waterfront Event Select AllThis field is hidden when viewing the formGroupAre you attending as a part of a larger group? For example, you are doing a climbing event with your youth group? Yes Group NameEnter your church group or organization name if you are attending as a part of a larger group.Activity DateList of Participant(s)(Required)Please everyone from your household who will be participating in the activity. Include the name of the person who is completing this form if that person is participating in the activity. Use “A” for adults in the age field.NameAgeAllergies Add RemoveEmail(Required) Address(Required) Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Phone number is required by state code for emergency contact.Enter Parent Name(Required)Enter the name of the person who is completing this form and is agreeing to the following participation agreement. First Last Participation Agreement(Required)I acknowledge that participation in the activity described above involves risk to the participant (and to the participant’s parents or guardians, if the participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, bodily injury, death, emotional injury, personal injury, property damage, and financial damage. In consideration for the opportunity to participate in the activity described above (the “activity”), the participant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with participation in, supervision if guardian of minor(s) and transportation to and from the activity. The participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the activity or during transportation to and from the activity, as well as for any medical treatment rendered to the participant that is authorized by Phantom Ranch or its agents, employees, volunteers, or any other representatives (collectively referred to as the “sponsor”). Further, the participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the activity sponsor for any injury arising directly or indirectly out of the described activity or transportation to and from the activity, whether such injury arises out of the negligence of the activity sponsor, the participant, or otherwise. If a dispute over this agreement or any claim for damages arises, the participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the participant (or parent/guardian) and the activity sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution in accordance with the rules of the American Arbitration Association. I have read this release of Liability and Assumption of Risk Agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.Paintball Agreement(Required)Paintball In order to participate myself or allow my child to participate, in any way, in the sport and activities of Paintball (also known as, Speedball) at Phantom Ranch Bible Camp, I acknowledge, and agree that: 1. There is a risk of injury, including a potential for permanent disability or death, resulting from any participation in the Paintball activities and from the equipment involved in participation, and while particular protective equipment and personal discipline will minimize this risk, the risk of serious injury does exist; 2. I knowingly and freely assume all such risks for myself or for my child, both known and unknown, even if arising from the negligence of those persons released from liability below, or from other participants, and assume full responsibility for my participating; 3. I understand, or my child understands, that there are rules of play, including safety related rules and agrees to fully comply with the rules and safety regulations during my participation, and that if I or my child does not understand the rules of play I or my child will seek further instructions; 4. I understand or my child understands, that the activities of Paintball are physically and mentally intense, and will comply with all rules and regulations. I understand or my child understands that failure to follow rules may result in eviction from Paintball activities without refund; 5. If I, or my child, observes any unusual or unnecessary hazard during my participation, I, or my child, will bring such to the attention of the nearest official as soon as practical; 6. I, for myself, or for my child, and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release and hold harmless from liability Phantom Ranch Bible Camp and Midwest Bible Church, Chicago, Il. (the owners and operators of the property used to conduct the Paintball activities), their officers, officials, board members, agents and or employees (‘releases’), with respect to any and all injury, disability, death, or loss or damage to person or property, whether caused by the negligence of the releases or otherwise, except that which is the result of gross negligence and/or wanton misconduct; 7. I understand and agree that this Release of Liability Agreement covers each and every Paintball activity and event in which I participate hereafter or my child participates hereafter. I have read the paintball release of Liability and Assumption of Risk Agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.Horsemanship Agreement(Required)This RELEASE of LIABILITY is made and entered into hereinafter designated PHANTOM RANCH BIBLE CAMP and hereinafter designated PARTICIPANT, and Participant’s parent/guardian (only enter if participant is minor). In return for the use of the property, facilities and services of the Manager, the Rider, his heirs, assigns, and legal representatives, hereby expressly agree to the following: 1. It is the responsibility of the Participant to carry full and complete insurance coverage on his personal property and himself. 2. Participant agrees to assume ANY AND ALL RISKS INVOLVED IN OR ARISING FROM THE PARTICIPANT’S USE OF OR PRESENCE UPON PHANTOM RANCH BIBLE CAMP’S PROPERTY AND FACILITIES including, but not limited to, the risks of death, bodily injury, property damage, falls, kicks, bites, collisions with vehicles, horses and other animals or stationary objects, fire or explosion, the unavailability of emergency medical care, or the negligence or deliberate act of another person. 3. Participant agrees to hold Phantom Ranch Bible Camp and all of its successors, assigns, subsidiaries, affiliates, officers, directors, employees and agents completely harmless and not liable and release them from all liability whatsoever and AGREES NOT TO SUE them on account of or in connection with any claims, causes of action, injuries, damages, cost or expenses arising out of Participant’s use of or presence upon Phantom Ranch Bible Camp’s property and facilities, including without limitation, those based on death, bodily injury, property damage, including consequential damages, except if the damages are caused by the direct, willful and want on negligence of Phantom Ranch Bible Camp. 4. Participant agrees to waive the protection afforded by any statute or law in any jurisdiction whose purpose, substance and/or effect is to provide that a general release shall not extend to claims, material or otherwise, which the person giving the release does not know or suspect to exist at the time of executing the release. 5. Participant agrees to indemnify and defend Phantom Ranch Bible Camp against, and hold it harmless from, any and all claims, causes of action, damages, judgments, costs or expenses, including attorney’s fees, which in any way arise from the Participant’s use of or presence upon the Phantom Ranch Bible Camp’s property and facilities. 6. Participant agrees to abide by all of Phantom Ranch Bible Camp’s rules and regulations. 7. This contract is non-assignable and non-transferable and is made and entered into the State of Wisconsin, and shall be enforced and interpreted under the laws of this state. Should any clause be in conflict with State Law, then that clause is null and void. When Participant and Participant’s parent or guardian, if Participant is a minor, sign this contract, it will then be binding on both parties, subject to the above terms and conditions. I have read the horsemanship release of Liability and Assumption of Risk Agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.CAPTCHA