Camper:__________________________________ Date of Birth:_______________________
Address: ___________________________________________________________________
Parent I Guardian: ___________________________________________________________
Parent I Guardian Telephone No.: ( ) ________________________.
IN CONSIDERATION of the camper's being permitted to participate in the
Camp operated by Camp Tapawingo Committee (here in 'The camp")
1. I, _________________(print name of Parent/Guardian), for myself, the camper,
____________________(print name of camper), my spouse, the camper's heirs, personal representatives, and assigns, hereby release, discharge and agree to hold harmless and indemnify the camp, its officers, directors, managers, counselors and any and all of its personnel of any from all liability, loss, claims, demands and possible causes of action that may accrue from any loss, damage or injury to person or property in any way resulting from or arising in connection with or related to the camper's participation at the camp.
It is fully understood that this means that the camp cannot be sued if any personal injury is suffered during the camp or if any property is damaged, lost, or stolen while the camper is at camp.
2. FURTHERMORE, I, on behalf of the camper, as well as for myself hereby
undertake to
Indemnify the camp against any and all liability, loss or damage from
which the camp may be found liable as a result of claims, demands or judgments
against the camp arising from any act or failure to act on the part of
the camper during the course of the camp, for which act or failure to act
either I or the camper may be found liable at law.
It is fully understood that this means that if the camper causes injury to another person or damages another person's property while at the camp, and the camp has to pay an amount to that person, the camp can recover the amount paid from me.
I HEREBY DECLARE THAT I HAVE READ THIS RELEASE AND INDEMNITY
AGREEMENT AND ACCEPT THE SAME IN FULL ON BEHALF OF MYSELF, MY
SPOUSE, THE CAMPER, THE CAMPER'S HEIRS, PERSONAL REPRESENTATIVES AND
ASSIGNS.
Signed at the________________ of ____________________________, In the
Province of ______________________.the _________ day of _____________
AD. 1999
Witness _______________________Parent/Guardian _________________________