This agreement (“Agreement”) is hereby made between First Baptist Church of Mountain Home, AR (“the organization”) and (“Participant”) who resides at the address listed within this form.

Organization Name: FBCMH

In consideration of being allowed to participate in any program, related events, and activities INCLUDING BUT NOT LIMITED TO HIGH ROPES, LOW ROPES OR INITIATIVES, RECREATIONAL EQUIPMENT USAGE AND ANY BALLFIELD ACTIVITES (“Programs”) at the Retreat, I, the undersigned Participant, acknowledge and agree that:

1. 
   

   The risk of injury from the activities involved in this program is significant. While rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist;

   
   


2. 
   

   I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, including that which arises FROM THE NEGLIGENCE OF THE Participant, the Camp, the Organization, or others, and assume full responsibility for my actions;

   
   


3. 
   

   I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest Retreat or Organization official immediately;

   
   


4. 
   

   I understand that photographs and video footage taken as a result of participation in the event may be used in the Retreat and/or Organizations materials, publications and/or posted to the Internet. By my signature below, I hereby grant world-wide, perpetual license of my image or my minor child’s image and agree to waive any right to inspect or to approve the materials that the Retreat and/or Organization may choose to publish in any manner;

   
   


5. 
   

   In addition to the extent this release is for myself, as an adult attending the Retreat, I understand the responsibility I have to supervise, protect and safeguard the children and youth with whom I am staying. I attest that I have not participated in behavior of moral turpitude that may cause the Retreat and/or Organization concern for my ability to be a Christian role model and to safely supervise minors.

   
   

I, the Participant, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS the the Retreat, the Organization, their officers, officials, trustees, agents and employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event WITH RESPECT TO ANY AND ALL SICKNESS, INJURY, DISABILITY, DEATH or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE of the Retreat and/or the Organization or their agents and employees or similar, to the fullest extent permitted by law; and I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, AND UNDERSTAND that I, by freely and voluntarily signing this Agreement, acknowledge the risk associated with participation.

(Under age 18 at time of registration)

This is to certify that I, the undersigned, as a parent/guardian with legal responsibilities for the Participant, hereby do consent and agree to his/her release as stated above, and, for myself, my heirs, assigns, and next of kin, I agree to indemnify and hold harmless the Retreat and/or the Organization for all incidents involving my minor child’s participation in the Programs to the fullest extent permitted by law.