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SPRINGHILL CAMPS

Indiana

Release of Liability, Waiver, Indemnification, and Consent to Medical Attention

In exchange for SpringHill Camps (“SpringHill”) allowing me to participate in and serve as a volunteer in connection with the program described below in Paragraph 1 (the “Program”), I, and if I am not yet 18 years old, my parent(s) or legal guardian(s) (individually and collectively referred to below in the first person singular), agree to be bound as follows:

1.  Program Description, Location, and Date(s). __________________________________________________________.

2.  Voluntary Participation. I understand and confirm that my participation in the Program and my service as a volunteer in connection with the Program is voluntary.

3.  Identification of Risks. I understand that there are certain dangers, hazards, and risks inherent in the Program.  More specifically, there are certain dangers, hazards, and risks inherent in certain activities conducted at the Program, including, but not limited to, climbing walls, inflatables, water games and events, and outdoor games (in the day camps), and swimming, horseback riding, river rafting, canoeing, paintball, extreme sports, high adventure activities, blobbing, winter tubing, snowboarding, skiing, cross country skiing, rock climbing, gymnasium activities, sports, zip line, rappelling, camp transportation, sleeping in tents or cabins, bathing and eating and other residential activities (in the overnight camps), all of which are regularly scheduled Program activities. I may voluntarily participate in some or all of these activities. I also understand that medical facilities or treatment may be inadequate or unavailable during portions of the Program.  I understand that my participation in the Program and my service as a volunteer in connection with the Program may involve risk of injury and loss, both to person and to property. I also understand that the risk of injury may include the possibility of permanent disability and death, and further may include the risk of exposure to COVID-19 (novel coronavirus). There also may be other risks not known to SpringHill and not reasonably foreseeable at this time. I further understand that some of the premises, facilities, and equipment used in connection with the Program may not be owned, maintained, or controlled by SpringHill, but rather by the premises owners (the “Premises Owners”). I understand that this Release of Liability, Waiver, Indemnification, and Consent is intended to address all of the risks of any kind associated with my participation or service as a volunteer in any aspect of the Program, including, particularly, such risks created by actions, inactions, or negligence on the part of SpringHill or its directors, officers, employees, agents, volunteers, successors, or assigns (collectively, the “Representatives”), including, but not limited to, risks created by the following: (a) the risk of exposure to COVID-19 (novel coronavirus); (b) my physical, emotional, and psychological limitations and/or discomfort; (c) the physical, emotional, and psychological limitations and/or discomfort of others; (d) the use and/or condition of premises on which various Program events occur; (e) the lack or inadequacy of policies, rules, or regulations with respect to the Program;  (f) the failure of SpringHill or its Representatives to foresee or to protect me from actions, inactions, negligence, recklessness, or intentional or criminal misconduct of other persons; (g) the inadequacy or unavailability of medical facilities, treatment, and/or professionals; or (h) the lack or inadequacy of supervision by SpringHill or its Representatives. 

4.  Assumption of Risk. I assume all risks, known and unknown, foreseeable and unforeseeable, in any way connected with my participation in the Program or service as a volunteer in connection with the Program, including (but not limited to) risks associated with exposure to COVID-19 (novel coronavirus). I accept personal responsibility for any liability, injury, loss, or damage in any way connected with my participation in the Program or service as a volunteer in connection with the Program, including (but not limited to) risks associated with exposure to COVID-19 (novel coronavirus).

5.  Release and Waiver. I release SpringHill and its Representatives from any and all liability, and waive any and all claims, for injury, loss, or damage, including attorneys’ fees, in any way connected with my participation in the Program or my service as a volunteer in connection with the Program, even if caused in whole or in part by the negligent acts or omissions or other misconduct of SpringHill or any of its Representatives, including (but not limited to) risks associated with exposure to COVID-19 (novel coronavirus) (a “Claim”). This release does not apply to reckless or intentional misconduct of SpringHill or any of its Representatives.

6.  Indemnification. I agree to indemnify and to hold harmless SpringHill and its Representatives, and the Premises Owners, from any Claim, or any expense, including reasonable attorneys’ fees for the legal counsel of SpringHill’s choice, in any way connected with a Claim, including the cost of defending any Claim released or waived by this instrument that I, or any member of my family, might make, or that might be made on my behalf, or on behalf of any member of my family.

7.  Criminal Background Checks Required for Volunteers Working with Children and Youth. If I am volunteering in a capacity in which I will work with any child or youth under the age of 18, I acknowledge that I will be required to complete the Criminal Background Check consent form attached as Exhibit A hereto before undertaking any such volunteer work.

8.  Binding Effect. This instrument shall be binding upon my relatives, personal representatives, heirs, beneficiaries, next of kin, and assigns and shall inure to the benefit of SpringHill and its Representatives.

9.  Consent to Medical Treatment. I authorize SpringHill and its Representatives, and the Premises Owners, if present, to provide to me, through medical personnel of their choice, customary medical assistance, transportation, and emergency medical services should I require such assistance, transportation, or services as a result of injury or damage related to my participation in the Program or my service as a volunteer in connection with the Program. This consent does not impose a duty upon SpringHill or its Representatives, or upon the Premises Owners, to provide such assistance, transportation, or services.

10. SpringHill Policies and Exposure Notice.  I agree to abide by any policies and procedures established by SpringHill for participation in the Program, including policies and safety measures intended to mitigate exposure to COVID-19 (novel coronavirus).  Moreover, I agree to notify SpringHill immediately if I learn that I have, or may have been, exposed to, or diagnosed with, COVID-19 (novel coronavirus), and that I will immediately cease my participation and service as a volunteer in the Program upon receiving such information. 

11. Severability. If any provision (or portion of any provision) of this instrument is held to be invalid or unenforceable, that provision shall be enforceable in part to the fullest extent permitted by law, and such invalidity or unenforceability shall not otherwise affect any other provision of this instrument.

12.  Applicable Law. Because SpringHill is located in the State of Indiana, and in order to provide certainty in the law to be applied in the construction of this instrument, this instrument shall be governed, construed, and enforced in accordance with the law of the State of Indiana.

Date: November 22, 2024

First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email
Check to receive other information from SpringHill!
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Program Description, Location, and Date(s)

Program Description, Location, and Date(s) *
If the person participating in the Program is not yet 18 years old, one of his/her parents or legal guardians must sign: In exchange for my child or ward being allowed to participate in the Program, and as the parent or legal guardian of the above named individual, I verify that I fully understand, agree to, and accept all provisions of this Release of Liability, Waiver, Indemnification, and Consent. I further represent and agree that I am signing on behalf of, and as an agent for, any other individual who may be a parent or guardian of my child or ward, that I am fully authorized to do so, and that by executing this Release of Liability, Waiver, Indemnification, and Consent, I am binding myself, any other parent or guardian of my child or ward, and my child or ward.


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*

Last Name*

Relationship*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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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