This agreement (“Agreement”) is hereby made between Arkansas Baptist Assembly, an Arkansas Non-profit Corporation d/b/a Camp Siloam (“the Camp”) and 
(“Participant”) who is attending with the organization below.

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 Camp, 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, 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 Camp official immediately;

   
   


4. 
   

   I understand that photographs and video footage taken as a result of participation in the event may be used in the Camp 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 Camp may choose to publish in any manner;

   
   


5. 
   

   In addition to the extent this release is for myself, as an adult attending Camp, 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 Camp concern for my ability to be a Christian role model and to safely supervise minors; and

   
   


6. 
   

   I understand the Camp has put in place certain measures to reduce the spread of COVID-19; however, the Camp cannot guarantee that I or my child(ren) will not become infected with COVID- 19 while attending the Camp. Further, I understand that attending the Camp could increase my risk and my child(ren)’s risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending the Camp and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Camp may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Camp employees, volunteers, participants and their families. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of the Camp, or its employees, agents and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Camp event or program.

   
   

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 Camp, their officers, officials, trustees, agents and employees, the Arkansas Baptist State Convention and its officers and its agents, officers and trustees, the Southern Baptist Convention and its agents, officers and trustees, 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 Camp 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 Camp for all incidents involving my minor child’s participation in the Programs to the fullest extent permitted by law.