INDEMNITY AND CONTRACT AGREEMENT: I will not hold or attempt to hold Young Life or MVP Foundation liable for any loss, damage or injury to person or property caused by any act or neglect of other persons on or about the Property, or caused in any manner other than the willful or negligent act of Young Life or MVP Foundation, its agents and employees, and will indemnify and hold Young Life and MVP Foundation harmless from any liability for damages or claims against Young Life or MVP Foundation arising out of or in any way related to any such loss, damage or injury.
I release Young Life and MVP Foundation, including its trustees, employees and agents, from my physical injury, including death, or illness while at the Property. I will assume the risk associated therewith, whether known or unknown to me at this time. This release is also intended to include all claims of my family, estate, heirs, personal representatives or assigns.
AUTHORIZATION FOR TREATMENT: I hereby give permission to the medical personnel selected by the camp director to secure and administer treatment and to maintain and/or release any medical records necessary for insurance purposes as outlined under the HIPAA regulation, and to provide or arrange necessary related transportation for the above named person.
To obtain a copy of Young Life’s Notice of Privacy Practices, log on to www.younglife.org or call (719) 867-3600.
I verify that I am or my child is in good health and am capable of participating in strenuous activities, and when necessary, will tailor my activities to those within the bounds of my physical health.
I recognize that any medical treatment and/or medical transportation that is provided to me or my child while attending a Young Life camp will be paid for by my medical insurance company
COVID-19: I recognize that a national emergency was declared because of the COVID-19 outbreak and that different states and/or counties/cities may be in various states of emergency. I recognize that even if Young Life and MVP Foundation has taken reasonable actions in light of COVID-19 and other coronaviruses, there is no guarantee that me or my child will not contract/transmit COVID-19 or other infectious or contagious illnesses or diseases while participating in activities and events at the Young Life property/camp, or traveling to and from, Young Life’s camp property and I release Young Life and MVP Foundation in the event of such an occurrence.
The Center for Disease Control (CDC) has identified that certain individuals are at Higher Risk for Severe Illness if they become ill with COVID-19. This includes those who have chronic lung disease, moderate/severe asthma, a serious heart condition, are immunocompromised, or have severe obesity, diabetes, or chronic kidney/liver disease or who are over the age of 65. Based on the CDC’s High-Risk criteria, you have determined if you want to participate in this event or if you want your child to participate in this event.
WAIVER AND RELEASE
If I am under the age of 18 my parent or guardian, by signing below, also consents to my release and he or she agrees that this release shall be binding upon him or her as my parent or guardian as to me and my estate, heirs, personal representatives and assigns. My parent or guardian also promises, by signing below to defend, indemnify and hold Young Life and MVP Foundation harmless from any claim asserted by me against Young Life and MVP Foundation, including its trustees, employees and agents, if I should repudiate this release after obtaining adulthood.
I understand and, to the best of my knowledge, confirm all of the above information is true and accurate.
By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.