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The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID19 is extremely contagious and is believed to spread mainly from person-to-person contact. Camp Canaan has put in place preventative measures to reduce the spread of COVID-19; however, the Camp Canaan cannot guarantee that you will not become infected with COVID-19. Further, participation could increase your risk of contracting COVID-19.

READ CAREFULLY BEFORE SIGNING – INITIAL EACH PARAGRAPH

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the
risk that I may be exposed to or infected by COVID-19 by participation; and that such exposure or infection may result in
personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by
COVID-19 at Camp Canaan may result from the actions, omissions, or negligence of myself and others, including, but not
limited to, the Camp Canaan employees, volunteers, and program participants and their families.

________________________________________________________________________

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself
(including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any
kind, that I may experience or incur in connection with my participation at Camp Canaan On my behalf, I hereby release,
covenant not to sue, discharge, and hold harmless Camp Canaan, its employees, agents, and representatives, of and from
the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto.
I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Camp
Canaan, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after
participation at Camp Canaan.

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I represent that I have adequate insurance to cover any injury or illness I may suffer or cause while
participating in this activity, or else I agree to bear the costs of such injury or illness myself. I further represent that I have
no medical or physical condition which could interfere with my safety in this activity, or else I am willing to assume – and
bear the costs of – all risks that may be created, directly or indirectly, by any such condition.

________________________________________________________________________

 In the event that I file a lawsuit, I agree to do so in the state where Camp Canaan is located, and I further
agree that the substantive law of that state shall apply. I agree that if any portion of this agreement is found to be void or
unenforceable, the remaining portions shall remain in full force and effect.

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By signing this document, I agree that if I am exposed or infected by COVID-19 during my participation in
this activity, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being
released on the basis of any claim for negligence.

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I have had sufficient time to read this entire document and, should I choose to do so, consult with legal
counsel prior to signing. Also, I understand that this activity might not be made available to me or that the cost to engage
in this activity would be significantly greater if I were to choose not to sign this release, and agree that the opportunity to
participate at the stated cost in return for the execution of this release is a reasonable bargain. I have read and
understood this document and I agree to be bound by its terms.

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 If I have signed a separate general waiver of liability connected to my participation at Camp Canaan, I agree
that the terms of that waiver are wholly incorporated into this document and that the terms of this document are
incorporated into the separate general waiver.

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I agree that I will practice safe social distancing and clean hygiene during my participation in any activities
and programs at Camp Canaan.

First Participant Name

First Name*

Middle Name

Last Name*

Phone*
First Participant Date of Birth*
First Participant Information

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First Participant Signature*
Second Participant Name

First Name*

Middle Name

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

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Third Participant Name

First Name*

Middle Name

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

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Fourth Participant Name

First Name*

Middle Name

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

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Fifth Participant Name

First Name*

Middle Name

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

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Sixth Participant Name

First Name*

Middle Name

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

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Seventh Participant Name

First Name*

Middle Name

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

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Eighth Participant Name

First Name*

Middle Name

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

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Ninth Participant Name

First Name*

Middle Name

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

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Tenth Participant Name

First Name*

Middle Name

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

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Parent or Guardian's Email Address

Email*

Confirm Email*
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Address

Address

City

State

Zip
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

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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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