Culture Clash Countdown:

WAIVER AND RELEASE AGREEMENT
As the parent(s) or custodial adult(s) of the participant registered on this form, I/we give permission for the retreat planning committee, its agents, staff, and volunteers to obtain urgent or emergency medical care for my/our child, and I/we authorize health care providers to render such care as may be necessary. It is understood that reasonable efforts will be made to contact me/us prior to obtaining such care, but I/we authorize such care whether I/we are contacted or not, and I/we agree to be financially responsible for such care.

I/we give permission for the participant registered on this form to participate in the activities of the retreat, both on the retreat premises and elsewhere. In consideration of the opportunity of my/our child/youth to participate in the activities of the retreat, I/we release the retreat planning committee, its officers, agents, employees, staff, and volunteers from any and all liability of any kind whatsoever for any loss or injury to my/our child/youth arising from my/our child/youth's participation in the activities of the retreat planning committee; and I/we agree to indemnify and hold forever harmless the retreat planning committee, its officers, agents, employees, staff, and volunteers from any and all liability of any kind whatsoever for loss or injury to my/our child/youth arising from activities on or off the premises of the ACR East event or resulting from traveling to or from the activities of the retreat planning committee, including loss or injury resulting from negligence or gross negligence. I/we understand and agree that this permission and agreement shall remain in effect until revoked in writing by me/us, and I/we understand and agree that it is my/our responsibility to update our child/youth's medical and insurance information as changes occur.