Mt. Morris Camp and Conference Center ASSUMPTION OF RISK
REGISTRATION FORM
All participants must sign forms 1,2 and 3.
I am aware in signing this document for participation in the Ropes and Challenge Course, that certain elements of the program can be physically and emotionally demanding. I understand that although the professional staff will make every reasonable effort to minimize exposure to known risks, not all dangers and hazards can be foreseen (i.e. cuts, scrapes, bruises, fractures, debilitating injuries, fatalities, etc.). Furthermore, I am aware that certain risks and dangers exist in these activities that are beyond the control of the sponsoring agency and it’s staff. I understand that Mt. Morris Camp and Conference Center has the right to deny participation and that it is my responsibility as a participant to follow the safety standards, guidelines, and procedures established by the staff/instructors. If I do not understand specific instructions from the staff/instructor at any time I realize it is my responsibility to ask for clarity and/or assistance.
In signing this document, I authorize the leader of the activities to secure such medical advice and services as deemed necessary from any health and safety---------- and agree to accept financial responsibility:
-Where my health and well-being is involved
-Where medical advice has been such that further services are required
-Where all reasonable attempts to contact family have failed or where the nature of the
emergency does not allow time to make contacts
-Where the benefits of my provincial health insurance plan have been exhausted and
additional loss of income and/or medical expenses are incurred.
I understand and assume all dangers and risks associated with this course and waive all claims against Mt. Morris Camp and Conference Center staff and assigns, it’s officers, shareholders, employees, volunteers, agents and their heirs, executors and assigns, for any incidents that should occur due to my voluntary participation in this experience. Furthermore, I give my consent to the instructors or other medical personnel to treat me in a medical situation. My signature on this document is also intended to bind my successors, heirs, representatives, administrators and assigns.
Participant’s Signature___________________________________ Date__________
Parent’s Signature ______________________________________ Date _________
(If participant is under 18)