LAKEVIEW CAMP AND RETREAT CENTER OF THE ASSEMBLIES OF GOD
EVENT WAIVER AND RELEASE
Participant _____________________________________________________ (“Participant”) plans to and will attend the
Lakeview Camp and Retreat Center of the Assemblies of God (“LCRC”) events or activities associated with:
__________________________________________________________________________ [name of LCRC event]
on these dates, unless extended: __________________________ (the “Event”). In consideration of being allowed to
participate in the Event held at or by the LCRC, Participant or his/her Parent or a legal guardian (“Parent”), if
Participant is not 18 years of age, acknowledges and agrees as follows:
1. Participant, or if Participant is a minor, Parent, individually and as legal guardian of
Participant, and on behalf of Participant’s and Parent’s heirs, assigns, and personal
representatives, WAIVES, RELEASES, AND AGREES TO HOLD HARMLESS LCRC AND NORTH TEXAS
DISTRICT COUNCIL ASSEMBLIES OF GOD AND THEIR DIRECTORS, OFFICERS, EMPLOYEES, VOLUNTEERS,
AND AGENTS, WHETHER OR NOT SPECIFICALLY NAMED HEREIN (COLLECTIVELY, “RELEASEES”), FROM
AND AGAINST ALL LIABILITY, BODILY INJURY, DEATH, DAMAGES OF ANY KIND, CLAIMS, CAUSES OF
ACTION, AND EXPENSES (INCLUDING ATTORNEY’S FEES) THAT MAY ARISE FROM OR RELATE TO
PARTICIPANT’S PARTICIPATION IN THE EVENT AND/OR ANY ACT, OMISSION, NEGLIGENCE OR
COMPARATIVE FAULT OF RELEASEES OR THIRD-PARTIES; PROVIDED, THAT RELEASEES ARE NOT
RELEASED FROM ANY SUCH LIABILITY OR DAMAGE ARISING FROM THEIR GROSS NEGLIGENCE OR
WILLFUL CONDUCT.
2. Participant, or Parent, individually and as legal guardian of Participant, understand
that there is risk of injury from the activities involved at LCRC, including bodily
injury, and while particular rules, equipment, and personal discipline may reduce this
risk, the risk of injury cannot be eliminated. Participant or Parent KNOWINGLY ASSUMES
ALL SUCH RISKS, both known and unknown, even if arising from the negligence of
Releasees, and assume full responsibility for injuries that may occur because of
Participant’s participation in LCRC Events.
3. If Participant observes any significant hazard during the Event, Participant agrees to
immediately remove himself/herself from participation and will immediately notify a LCRC
official or volunteer.
4. Participant, or Parent, individually and as legal guardian of Participant, agree that if
any provision herein shall be for any reason unenforceable, then that provision shall be
severed from this Release and does not affect the validity and enforceability of any
remaining provisions. I have read this Event Waiver and Release and understand its
terms, and I sign it voluntarily.
____________________________ __________________________________ __________
Participant’s Signature Participant’s Printed Name Date
Parent Signature – Required if Participant is Under 18 Years of Age
I certify that I am a parent or legal guardian of Participant, and that
Participant is fully capable of participating and is permitted to participate in
the LCRC Event. The “EVENT WAIVER AND RELEASE” shall be fully enforceable as
between LCRC and Participant and me, individually and as legal guardian of
Participant.
____________________________ __________________________________ __________
Parent’s Signature Parent’s Printed Name Date
