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Rotary Club of Tulsa Camp Enterprise 2026
Parent / Guardian Waiver and Release - English

The undersigned ("Guardian") certifies he or she is at least 18 years old and is the legal guardian of the above-identified student (the "Student"). In consideration of the Student being permitted to participate in CAMP ENTERPRISE at Camp Victory in Mannford, OK (the "Camp") on April 9th through April 12th, 2026. The "Program" which term also includes participation to and from the Camp) sponsored by Tulsa Rotary Club ("Rotary" which term shall also include its respective officers, members, agents, volunteers and employees), Guardian and on behalf of the Student agrees as follows:

Guardian authorizes: (a) Rotary to call for medical care for the Student or to transport the Student to a medical facility or hospital if, in the opinion of Rotary, medical attention is needed for the Student; and (b) appropriate medical personnel to render such medical treatment as is necessary for the health of the Student.

Guardian acknowledges: (a) the Student's participation in the Program involves numerous activities, some of which may involve inherent risks or dangers not normally found or associated with the Student's usual and customary life style (including without limitation living in dormitories with bunk beds, sports activities such as climbing walls, trust falls, zip cable and other activities customarily available at supervised camps for students located in wooded outdoor camp areas); (b) it is commercially unreasonable for Rotary or the Camp to eliminate such risks or dangers. Guardian has either discussed the Program and the facilities at Camp with Rotary or has had the opportunity to do so and is satisfied that Guardian understands all such additional risks and dangers.

Guardian consents to Student's participation in the Program and accepts any and all responsibility for all risks and dangers that may be associated with or result from the Student's participation in the Program including any activity associated with the Program or in any way related to the Program or transportation of the Student in connection with the Program.

Guardian for himself/herself, the Student and Guardian's or Student's respective heirs, successors, and assigns, hereby knowingly and intentionally waive and release (each of the following is referred to as a "Released Person"): (a) Rotary; (b) the Student's school district; (c) the owners and operators of the Camp; and (d) the State of Oklahoma from and against any and all liability, loss, claims, actions, causes of action, damages, suits, expenses (including reasonable attorney's fees) of any kind or nature, whether foreseeable or not (collectively "Liabilities"), resulting or arising directly or indirectly out of the Student's participation in the Program, any activity associated with the Program or in any way related to the Program or transportation of the Student in connection with the Program, including transportation to or from the Camp, or to persons or property which the Student may cause or contribute to, including without limitation any and all Liabilities for damage, injury, paralysis or death to the Student resulting from such participation, whether or not such damage, loss, injury, paralysis or death results from the ordinary negligence of a Released Person or from some other cause. The terms of this release and waiver shall be severable.

Guardian shall protect, indemnify, defend and hold harmless each Released Person and each other student participating in the Program from any and all Liabilities arising or resulting directly or indirectly, partially or entirely, from the Student's participation, conduct or misconduct in the Program.

Guardian specifically understands that Student will be dropped off at approximately 1:00 p.m. on Sunday April 12, 2026 at a location to be designated by Rotary and communicated to Guardian (the "Drop-off Location"). Guardian is solely responsible for picking up the Student at that place and time. Guardian specifically understands that: (a) there are no facilities for the Student to wait at the Drop-off Location; (b) there is no adult supervision at the Drop-off Location; (c) there is no ability to contact Rotary to inform it that Guardian will be late in picking up the Student; and (d) no public transportation serves the Drop-off Location. Guardian undertakes and agrees to personally (or through an agent) timely appear at the Drop-off Location and to ensure that the Student will not be left unsupervised at the Drop-off Location.

I HAVE CAREFULLY READ, UNDERSTAND AND VOLUNTARILY ACCEPT THE TERMS OF THIS AGREEMENT: PARENT/GUARDIAN

Date for Approval: April 2, 2026

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First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
Information

The Student is in good health, there are no special problems associated with the care of the Student. Guardian has provided Rotary with no instructions regarding the Student and Student is taking no medications, except as follows:

Medication / care instructions:

Do you have any special dietary requirements? (E.g. allergies, diabetic etc.) If so, please tell us what they are:

Dietary requirements / allergies:

In case of emergency, Parent/Guardian authorizes Rotary to contact the following person:

Name:
Relationship to Student:
Address:
City, State & Zip:
Telephone:
Cell Phone:

Guardian grants Rotary the royalty-free right to use, publish and copyright Student's name, voice, picture, portrait or likeness in all media and types of advertising and commercial and non-commercial promotion of the Program and future CAMP ENTERPRISE programs

Media permission: Accept / Decline
Accept
Decline
First Participant's Signature*
Parent or Guardian's Email Address
Email*
Confirm Email*
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Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Middle Name
Last Name*
Relationship*
Parent or Guardian's Date of Birth*
Date of Birth
Information

The Student is in good health, there are no special problems associated with the care of the Student. Guardian has provided Rotary with no instructions regarding the Student and Student is taking no medications, except as follows:

Medication / care instructions:

Do you have any special dietary requirements? (E.g. allergies, diabetic etc.) If so, please tell us what they are:

Dietary requirements / allergies:

In case of emergency, Parent/Guardian authorizes Rotary to contact the following person:

Name:
Relationship to Student:
Address:
City, State & Zip:
Telephone:
Cell Phone:

Guardian grants Rotary the royalty-free right to use, publish and copyright Student's name, voice, picture, portrait or likeness in all media and types of advertising and commercial and non-commercial promotion of the Program and future CAMP ENTERPRISE programs

Media permission: Accept / Decline
Accept
Decline
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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