Parent/Guardian (If Attendee is a Minor)
Emergency Contacts
Medical Information
I, and my parents or legal guardian (if a minor), am/are fully informed about and aware that during my stay at Trinity Pines Conference Center, Trinity, TX, also known as Trinity Pines, certain risks and dangers may occur. These include, but are not limited to, the hazards t at arise from being in a wilderness area, the forces of nature and other hazards arising out of the content of this program which include, but are not limited to, activities such as volleyball, soccer, softball, basketball, archery, wilderness hiking, swimming, use of watercrafts, and an adventure course with zip lines, high and low elements (collectively referred to as the “Activities”). I authorize the use of my or my child’s photograph or video on the Trinity Pines electronic and print media for updates, communication, and marketing.
I am aware that, being in close contact with other campers and staff, whether church staff, counselors, recreational staff, Trinity Pines staff, agents, or contractors, I may be exposed to one or more viral infections or other infectious diseases. I acknowledge and understand the risks associated with any and all such infectious diseases, as well as preventative measures utilized to slow and/or prevent the spread of such infectious diseases, including but not limited to frequent hand washing, social distancing and use of face masks in public locations, and I hereby willingly choose to participate in the Activities.
In consideration of Trinity Pines providing and my willingness to engage in these rigorous activities in a special envir nment, I have and do hereby hold Trinity Pines, it’s owners, officers, directors, trustees, agents, employees, and/or volunteers, harmless from any and all claims, liabilities, suits, actions, causes, damages or losses and demands of every kind and nature whatsoever, including without limitation, all costs a d attorney’s fees, which may arise from or in connection with my stay or participation in any activities arranged for me by my organization or my group le ders or Trinity Pines. Injuries may include, but are not limited to, emotional injuries, physical injuries, or death. The terms hereby shall serve as a release and assumption of risk for me, my heirs, executors, administrators, and for all members of my family. I certify that I/my child are current on required immunizations, or are exempt from immunization requirements for reasons of conscience.
In case of an accident or illness, I authorize first aid/medical personnel to examine, treat, or administer medications for any illness or injury to myself or my child as deemed necessary. In the event of an emergency involving my child and if I cannot be reached by telephone, I authorize such persons to obtain any medical care (including hospitalization, injection, anesthesia, and surgery) from a licensed, certified, or authorized h alth care provider for my child as deemed necessary. I accept sole responsibility for the payment of any medical care for me or my child. I hereby release, indemnify and hold harmless Trinity Pines, it’s owners, officers, directors, trustees, agents, employees, and/or volunteers, from and against any and all claims, liabilities, or damages arising from any act or omission of an any such of Trinity Pines, it’s agents, and employees.
I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as permitted y the law of the State of Texas and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto and the terms of this release are contractual and not a mere recital.
I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND I SIGN THIS RELEASE AS
MY OWN FREE ACT. This is a legally binding agreement, which I have read and have understood.
