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GUEST CONSENT AND RELEASE FORM

I and/or my minor child will be attending Tejas Ministries, Inc. {hereinafter referred to as "Tejas", and as further defined below} on June 23-27, 2021. At all times when I am at Tejas I acknowledge that I will be under the direct supervision of Clear Creek Community Church {herein known as the "Sponsoring Organization"}. 

I, for myself and/or the minor child for which I am responsible, hereby acknowledge the actions taken by Tejas for the protection and prevention of the spread of infectious diseases including, but not limited to, COVID-19. I acknowledge the below COVID-19 health warning:

We have taken enhanced health and safety measures—for you, our other guests, and our staff. You must follow all posted instructions while visiting Tejas Camp and Retreat. An inherent risk of exposure to COVID-19 exists in any place where people are present. COVID-19 is an extremely contagious disease that can lead to severe illness and death. According to the Centers for Disease Control and Prevention, senior citizens and guests with underlying medical conditions are especially vulnerable. By visiting Tejas Camp and Retreat, you voluntarily assume all risks related to exposure to COVID-19.

I, for myself and/or the minor I am responsible for, our heirs, personal representatives and assigns, do hereby release, waive, indemnify, and discharge Tejas, its owners, directors, partners, officers, agents, representatives and employees, from LIABILITY from ANY and ALL claims resulting in personal injury, accidents, or illnesses (including COVID-19 and other infectious diseases), death, and property loss arising from, my actions, and/or the actions taken by my Sponsoring Organization while I am at Tejas, and I further hereby covenant not to sue Tejas or its owners, directors, partners, officers, agents, representatives and employees for any such claim.
 

I, for myself and/or the minor I am responsible for, agree to indemnify and HOLD HARMLESS Tejas and its owners, directors, partners, officers, agents, representatives and employees from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees brought by me as a result of my actions, and/or the actions taken by my Sponsoring Organization while I am at Tejas,.

I authorize Tejas to make arrangements for, or give any medical attention to me as Tejas deems necessary under the circumstances, at the sole discretion of Tejas. I also give permission to any medical care providers summoned by Tejas, including every doctor or other medical professional, to hospitalize me and/or secure such other medical treatment as Tejas and the medical professional deem appropriate. I further understand that emergency medical treatment may be difficult to obtain, and in some instances appropriate treatment may be delayed because Tejas is located in a country setting miles away from an incorporated town and/or hospital. I release, waive, indemnify and hold harmless Tejas from any harm that is occasioned me due to any delay in treatment of a medical condition.

I understand, and agree to assume all risks which I may encounter while at Tejas, including activities preliminary to my visit, while I am at Tejas and subsequent thereto. I understand and assume all risks for activities I engage in while I am a guest at Tejas, recognizing and acknowledging that many of these activities that I undertake at Tejas are inherently dangerous such as riding a zip line, swimming in a lake, swimming in a pool, hiking, shooting bows and arrows, and other such related activities. I release, waive, indemnify and hold harmless Tejas, their officers, directors, agents, employees, affiliates, volunteers and representatives {sometimes either defined and/or referred to herein collectively as "Tejas" or "Indemnified Parties"} from and against all liability, damages, causes of action, claims, losses and/or expenses, including but not limited to attorney's fees, court costs and expenses, medical costs, and like expenses, which may be related to any injury or death to me, or any person related to me. I also
release, indemnify and hold harmless Tejas, and the Indemnified Parties from any loss or damage to property, including loss of use thereof, caused in whole or in part by Tejas or the Sponsoring Organization, whether such loss was caused in whole or in part by negligence of the Indemnified Parties, or any one or more of them .This release, however, will not apply in the event of willful misconduct.

I further give my permission and consent to Tejas to use any photograph, or video taken of me while at Tejas for any purpose. I also give my permission to Tejas to use any interview of me, which is reduced to writing, or kept in an audio recording, using whatever platform. Such photographs, videos and/or audio recordings may be published by Tejas for the purpose of illustrating Tejas, reporting on Tejas activities, or for the purpose of promoting and advertising Tejas. My permission extends to Tejas to use photographs, videos or audio recordings of me however they see fit in every kind of media, including, but not limited to, print media, broadcast media, and on the internet, Facebook, Twitter and any other website based platform that is used by Tejas to report on Tejas to the general public, and/or for internal purposes - including training. I assign full copyright authority to Tejas for photographs, videos or audio recordings of me and claim no interest in the reproduction of these media resources either wholly or in part. I agree that photographs, videos and/or audio recordings can be used separately, or together, whole or in part, in any medium at the sole discretion of Tejas.

Should any dispute arise from this agreement, I agree to first seek to mediate such dispute in good faith with a qualified mediator acceptable to Tejas and me. Should we not be able to agree on a mediator, I agree that the Senior District Judge in Lee County, Texas will appoint a mediator to mediate the dispute. I also agree that venue for any dispute, or cause of action, arising by and between the parties, whether arising out of this agreement or otherwise, can only be brought in a court of competent jurisdiction in Lee County, Texas, exclusively, and exclusive of any provisions relating to conflict of laws.

I expressly agree that this release, waiver, indemnity and hold harmless agreement is intended to be broad and inclusive as permitted by the law of the State of Texas and that if any portion thereof is held invalid, I agree that the balance of this agreement shall, notwithstanding, continue in full force and legal effect. I also agree that in the event I take any legal action against Tejas, which is decided in favor of Tejas, I agree to be responsible for all legal fees, court costs and out of pocket expenses incurred by Tejas. This release, waiver, indemnity and hold harmless agreement is the entire agreement by and between the parties hereto and the terms of this release, waiver, indemnity and hold harmless agreement are contractual and not merely a recital.

I further state that I have carefully read the forgoing, I have been given full opportunity to consult with an attorney of my choosing, and having done so I sign this release, waiver, indemnity and hold harmless agreement as my own free act. I acknowledge that this is a legally binding document, which I have read, understood and accept to be fully bound by from and on the date of the signing of this agreement and thereafter.

Signed on September 28, 2021

First Camper Name

First Name*

Middle Name

Last Name*

Phone*
First Camper Date of Birth*
First Camper Information

Email Address

Cell Phone
First Camper Signature*
Second Camper Name

First Name*

Middle Name

Last Name*
Second Camper Date of Birth*
Second Camper Information

Email Address

Cell Phone
Third Camper Name

First Name*

Middle Name

Last Name*
Third Camper Date of Birth*
Third Camper Information

Email Address

Cell Phone
Fourth Camper Name

First Name*

Middle Name

Last Name*
Fourth Camper Date of Birth*
Fourth Camper Information

Email Address

Cell Phone
Fifth Camper Name

First Name*

Middle Name

Last Name*
Fifth Camper Date of Birth*
Fifth Camper Information

Email Address

Cell Phone
Sixth Camper Name

First Name*

Middle Name

Last Name*
Sixth Camper Date of Birth*
Sixth Camper Information

Email Address

Cell Phone
Seventh Camper Name

First Name*

Middle Name

Last Name*
Seventh Camper Date of Birth*
Seventh Camper Information

Email Address

Cell Phone
Eighth Camper Name

First Name*

Middle Name

Last Name*
Eighth Camper Date of Birth*
Eighth Camper Information

Email Address

Cell Phone
Ninth Camper Name

First Name*

Middle Name

Last Name*
Ninth Camper Date of Birth*
Ninth Camper Information

Email Address

Cell Phone
Tenth Camper Name

First Name*

Middle Name

Last Name*
Tenth Camper Date of Birth*
Tenth Camper Information

Email Address

Cell Phone
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
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.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Email Address

Cell Phone
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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