I hereby grant permission for my child __________________________________________ to participate in any and all activities
and/or programs provided by or through Green Swamp Youth Campers These activities and/or programs may include,
but are not limited to: camping, canoeing, kayaking, white water rafting, inner tubing, snorkeling, rock climbing, rappelling,
caving, backpacking, team building, individual & team sports, individual & group games.
I hereby agree as follows: I fully understand and acknowledge that: (a) risks and dangers exist in my child's participation
and equipment use of activities including, but not limited to: camping, canoeing, kayaking, white water rafting, inner tubing,
snorkeling, rock climbing, rappelling, caving, backpacking, team building, individual & team sports, individual &
group games; (b) my child's participation in such activities and/or use of such equipment may result in personal property
damage and/or injury and/or illness and/or death; (c) these risks and dangers may be caused by other participants, or by accidents,
or by the forces of nature, or by other persons and/or other causes. Risks and dangers may arise from foreseeable and/or unforeseeable
causes that are inherit hazards and dangers of any activity or program taking place in an outdoor and/or recreational environment
including while transporting to and from said activities; and (d) I hereby accept and assume these risks and dangers.
I hereby affirm that my child is not allowed to use nor be under the influence of alcohol or controlled substances. I hereby
affirm that my child is to obey all safety requirements that govern each activity which include but are not limited to such
things as wearing an approved personal flotation device and/or helmet and/or harness and/or gloves. I hereby affirm that my
child is not to use nor be in the possession of any tobacco products, dangerous or violent weapons, obscene materials, or
any other item or items that may cause personal harm and/or disruption to others.
I understand that strenuous physical exertion may be required and my child has no known physical disabilities or
health conditions which will or may present any risk to his or her participation in the activities or programs as provided.
I release and agree to indemnify and hold harmless the volunteers, officers, and persons involved with Green Swamp Youth Campers
from any and all incidents and/or liabilities to my child's participation in these activities and/or programs to the fullest
extent permitted by law, even if arising from negligence. I agree not to press any disputes or claims against the Green
Swamp Youth Campers or any person associated with the group. I understand that the Youth Campers have no physical or
monetary assets and that individual that volunteer their time and possessions do so on the grounds that I will not hold
anyone liable for volunteering so that the group may function. I understand that the Green Swamp Youth Campers is not
a legal entity, is not incorporated, and has no assets. I understand that the volunteers do so as Good Samaritans trying to
provide worthwhile activities for young people and as such are protected by law, the Good Samaritan Law, against lawsuits.
I hereby permit the activity and/or program coordinators and its agents to photograph, post online, videotape, or by any
other means record my child's image or voice or writings for the purpose of instructional, promotional, or archival use.
The above agreement shall be binding on my heirs, successors, assigns, administrators and executors.
I HAVE READ THE ABOVE AND BY SIGNING IT AGREE THAT IT IS MY INTENTION TO GRANT PERMISSION FOR MY CHILD
TO PARTICIPATE IN GOING THE GREEN SWAMP YOUTH CAMPERS ACTIVITIES AND/OR PROGRAMS, AND TO ASSUME AND ACCEPT ALL ASSOCIATED
CHILD's PRINTED NAME:___________________________________________________ AGE: _______________
CHILD's SIGNATURE: _____________________________________________________ DATE: ______________
PARENT/GUARDIAN's PRINTED FULL NAME: _______________________________________________________
PARENT/GUARDIAN's SIGNATURE: ___________________________________________ DATE: _____________