This is for those who have already applied for camp.

A signed form for each participant must be received by Youth Outreach Ministry before participant may participate.

I understand and agree that I am assuming for myself and the Participant named below all risk of injury from participating in rock climbing activities, surfing on the FlowRider® or paintball games. I understand that: (1) injuries while rock climbing may occur from rope entanglements, objects falling from or being dropped by other climbers, or from contact with anchor points, bolts, or equipment used in climbing; (2) injuries while using the FlowRider® may occur by falling or being thrown by the water pressure onto a fixed surface or padded retaining wall, or by contact with the body board; (3) the activities of paintball are physically and mentally intense, injuries while participating in paintball games may occur due to the activity and weaponry involved, and while particular protective equipment and personal discipline will minimize the risk, the risk of injury does exist and (4) other unforeseeable injuries may occur from these activities. I hereby waive, release, and agree not to sue Youth Outreach Ministry, Inc., Pensacola Christian College, Inc., its affiliates or subsidiaries, and any of their officers, directors, employees, agents, students, successors or assigns for any damage, injury, cost or cause of action arising from any participation in these activities.

I voluntarily sign this waiver, release and agreement not to sue with full knowledge of the nature and extent of the risks inherent in the use of the rock climbing wall, FlowRider®, and paintball. I further indemnify and save Youth Outreach Ministry, Inc., Pensacola Christian College and its affiliates, employees, and agents harmless from any liability or medical payments resulting from my child's participating in this camp or other activities during his or her stay at summer camp. I further understand that Youth Outreach Ministry, Inc. does not provide medical insurance coverage for my child and any medical expense incurred will be paid by me or my insurance. I hereby grant permission for my child to attend the camp, participate in all the camp activities, and to be treated by a licensed medical professional in the event of any injury, accident or illness or other situation that may require medical attention. I give permission for my child's picture to be used in future publications including publications from PCC and its affiliate web pages. I understand the enclosed registration fee is non refundable and non transferable. Campers that use tobacco, alcohol or any form of illegal drugs will be dismissed. Any non-cooperative or non-compliant campers will be subject to dismissal.

   
Participant's (Camper) Signature Legal Guardian's Signature (Only if participant is a camper.)
   
Participant's (Camper) Printed Name Legal Guardian's Printed Name
   
Date Date
Church youth group:  
  Church
Youth Pastor:  
   
Phone: ( )

Send this signed form by mail to Youth Outreach Ministry, P.O. Box 18500, Pensacola, FL 32523 or by fax to 850-479-6576.