RELEASE OF LIABILITY STATEMENT

I, the undersigned, understand that there are inherent risks of personal injury or property damage that accompany our participation in this Camp Ao-Wa-Kiya program. By signing below I acknowledge that I have satisfied myself as to the nature of activities I or my child will be participating in, the risks associated with such activities, the concept of “Challenge by Choice,” and the necessity to know my or my child's own limits and to assume responsibility for my or my child's actions. I acknowledge that if I or my child have pre-existing medical conditions that would inhibit my or my child's ability to participate safely in the program, such as pregnancy, seizure disorder, etc. It is my responsibility to inform the lead facilitator, knowing that I or my child's experience may be altered for safety. I affirm that I understand that I am or my child is free to choose not to participate in any activity, and hereby release Camp Ao-Wa-Kiya, its staff members, its governing organizations, its officers, trustees, employees, agents, and all other persons associated with Camp Ao-Wa-Kiya from any and all liability, damages, claims, demands, actions, and causes of action of any kind or description arising out of or in any way related to any activity that I or my child may participate in at Camp Ao-Wa-Kiya. I do further agree to indemnify and hold harmless any party herein or by any third party arising out of or in any way related to any actions or activities while at Camp Ao-Wa-Kiya. I understand that I have sufficient insurance coverage and that it will act as the primary insurance coverage for my or my child’s participation in this Camp Ao-Wa-Kiya activity.

Retreat/Group Name

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Digital Signature

Camper Name

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Parent of Guardian Name

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Parent or Guardian Signature