PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK
The purpose of this agreement is to exempt, waive, release, and relieve the “Releasees” identified below from any and all liability, claims, losses, costs or damages, including, but not limited to, personal injury, property damage or wrongful death associated with Mountain Wisdom, Inc., including all programs and events sponsored and facilitated by Mountain Wisdom, including the Young Men’s Ultimate Adventure Camp and the Young Women’s Empowerment Journey Camp.
The Releasees include:
Mountain Wisdom, Inc., including all programs and events sponsored and facilitated by Mountain Wisdom, including the Young Men’s Ultimate Adventure Camp and the Young Women’s Empowerment Journey Camp, owners Jay and Terry Zipperman, individually, together with all directors, volunteers, participants, employees, representatives, agents, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as “Mountain Wisdom”).
Wilderness Works and Emmanuel Baptist Church at 644 Memorial Dr. SE, Atlanta, GA 30312.
Robert Lipman and Tri-Mountain Retreat, 1163 Hard Slate Road Elliay, Ga 30536
I acknowledge, agree and represent that I understand that the nature of all wilderness recreational activities entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, or damage to myself, to property or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the program. These risks include (but are not limited to) camping, hiking, repelling, archery, the hazards of walking on uneven terrain, slips and falls, the forces of nature (including lightning and rapid weather changes), hypothermia, the risks of exposure to insect bites, the risks of snake bites, my own physical condition and the physical exertion associated with all the activities. These risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the activities, the conditions in which the activities take place, or the negligence of the “Releasees” named above. I fully accept and assume all such risks and responsibility for any and all losses, costs, expenses, and damages I incur as a result of my participation in Mountain Wisdom, Inc., including all programs and events sponsored and facilitated by Mountain Wisdom, including the Young Men’s Ultimate Adventure Camp and the Young Women’s Empowerment Journey Camp.
Release for Indigenous Ceremonies
During the time in camp, campers will be invited to participate in indigenous-based ceremonies which may require physical exertion. These activities may include but are not limited to sleeping outdoors without a tent, ceremonial dancing, or purification lodges. Campers are not required to participate, and staff carefully monitor the health and well-being of each child.
I HEREBY RELEASE, WAIVE, RELINQUISH, DISCHARGE AND COVENANT NOT TO SUE THE RELEASEES FROM ALL LIABILITIES, CAUSES OF ACTION, CLAIMS, DEMANDS, LOSSES, EXPENSES, OR DAMAGES OF ANY KIND DIRECTLY OR INDIRECTLY CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE ACTIONS OF THE RELEASEES OR THIRD PARTIES, INCLUDING NEGLIGENT RESCUE OPERATIONS, RELATED DIRECTLY OR INDIRECTLY TO MOUNTAIN WISDOM, INC., INCLUDING ALL PROGRAMS AND EVENTS SPONSORED AND FACILITATED BY MOUNTAIN WISDOM, INCLUDING THE YOUNG MEN’S ULTIMATE ADVENTURE CAMP AND THE YOUNG WOMEN’S EMPOWERMENT JOURNEY CAMP(COLLECTIVELY, THE “RELEASED CLAIMS”). I FURTHER AGREE TO INDEMNIFY AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEYS FEES, LIABILITIES, CAUSES OF ACTION, CLAIMS, DEMANDS, LOSSES, EXPENSES, OR DAMAGES OF ANY KIND FROM ANY RELEASED CLAIMS ASSERTED AGAINST RELEASEES BY OR THROUGH ME OR BY ANYONE ACTING IN CONJUNCTION OR IN CONCERT WITH ME.
In case of emergency, I hereby give permission to the physician, paramedic, or medical staff selected by the staff of Mountain Wisdom, Inc., including all programs and events sponsored and facilitated by Mountain Wisdom, including the Young Men’s Ultimate Adventure Camp and the Young Women’s Empowerment Journey Camp, to administer treatment as deemed necessary for the below Camper.
I do support and agree to abide by all camp regulations and policies. If I am being defiant, disruptive, or exhibiting behavior that could be harmful to myself, other campers, or staff, the staff will call legal authorities or parents to pick up the camper immediately. I also understand that due to the nature of the camp budget, if the camper is required for any reason to leave the camp, there will be no refunds given.
Mature Audience Conversations
Though it is not the intention of Mountain Wisdom or its programs to provide sex education, campers may bring up such conversations. Mountain Wisdom encourages teens to show respect for themselves and their parents. From this perspective, we support teens in following guidelines created by their parents from a place of respect and honor.
I understand campers may be photographed for use by news media, publications, advertising, or promotional materials, and I consent for Mountain Wisdom, Inc., including all programs and events sponsored and facilitated by Mountain Wisdom, including the Young Men’s Ultimate Adventure Camp and the Young Women’s Empowerment Journey Camp, to use all such photographs of the below Camper.
CONFIDENTIALITY RELEASE
Mountain Wisdom, Inc. is a nonprofit organization that offers outdoor experiences for children. While participants may experience therapeutic benefits from the programs, they are not intended to be therapeutic. Mountain Wisdom is committed to professionalism regarding confidentiality, though it is not held to therapeutic standards.
Everything that happens during camps is to be held confidential. Participants may discuss what happens to them personally and insights they receive, but may not share specific information about activities or any information about other participants. This confidentiality applies unless a participant is in danger or unsafe. This includes danger to oneself or others and any situation involving physical, emotional, or other abuse or mistreatment. In such cases, proper authorities will be immediately notified.
I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.
I am in favor of the Camper attending Mountain Wisdom, Inc., including all programs and events sponsored and facilitated by Mountain Wisdom, including the Young Men’s Ultimate Adventure Camp and the Young Women’s Empowerment Journey Camp, and participating in all activities unless I specify otherwise in writing. I agree to all terms and conditions contained within this document for myself and on behalf of the Camper. I expressly represent and warrant that I am the legal guardian of the Camper.
I further agree to indemnify and hold the Releasees harmless from any and all claims brought by or on behalf of the Camper that are in any way connected to participation in these programs.
