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 2024 WAIVER AND RELEASE OF LIABILITY FORM

(FOR ADULTS ONLY)


 “Activity” or “Event” shall be defined to include any activity or event lead by Outdoor Adventures Club during 2024, which shall include hiking, camping, backpacking, traveling in personally owned vehicles, traveling by airplane, traveling by taxi, traveling by rental car, climbing mountains, swimming, playing sports, skiing, snowboarding, fishing, hunting, sledding, all retreats, Boot Camp, Walkabout, tryouts for Bootcamp and Walkabout, parties, domestic and international mission trips, classes, food eating contests, concerts, eating at restaurants, watching movies and any other events promoted by Outdoor Adventures Club or otherwise.

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING AND/OR VOLUNTEERING IN THIS ACTIVITY OR EVENT, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. I understand and certify that my participation in this Activity or Event is completely voluntary. I have familiarized myself with this Activity or Event in which I will be participating. I understand that I will be transported by Outdoor Adventures Club volunteers, employees, directors or officers in their privately owned vehicles to and from the Event or Activities, as well as to or from the Event’s training sessions. I recognize that certain hazards and dangers are inherent in the transportation involved, as well as in regard to this Event and these Activities, which may include, but are limited to, tent camping, water crossings, exposure to unpredictable weather, hiking and camping in the vicinity of wildlife, hiking and camping at high elevation, and hiking and camping in the vicinity of poisonous plants and insects. I acknowledge that although Outdoor Adventures Club has taken safety measures to minimize the risk of injury to Event participants, Outdoor Adventures Club cannot insure or guarantee that the participants, transportation, equipment, premises or Activities will be free of hazards, accidents or injuries. I recognize the importance of knowing and abiding by the rules, regulations, and procedures of this Event and these Activities.

Outdoor Adventures Club Events involve activities that require participation in various physical exercises, ranging from mild to strenuous physical exertion. It is the responsibility of you, as either the participant or the legal guardian of the participant, to determine whether you have any medical or physical conditions which might create risk to yourself and/or others. Please carefully consider your medical and physical condition, including, but not limited to, whether any of the following or any other medical and/or physical condition apply to you and if there is any doubt about your ability to safely participate, please consult with a physician before participating in the Event: heart condition/disease, high blood pressure, unstable cardiovascular or respiratory conditions, uncontrolled diabetes, dizziness, fainting, epilepsy, seizures, recent liver or kidney transplant recipient, problems with your neck, back, joints, current broken bones/strains, recent operation or serious injuries.Participation in ALL Outdoor Adventures Club Events is completely voluntary, and you can decline participation in all or any part of the Events at any time.

I certify that I am physically fit, have sufficiently prepared or trained for participation in the Activity or Event, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this Activity or Event. I CERTIFY THAT IF I SUFFER A MEDICAL EMERGENCY WHICH REQUIRES A DOCTOR'S VISIT, URGENT CARE VISIT OR EMERGENCY ROOM VISIT, THAT I WILL COVER ALL OF THE MEDICAL EXPENSES INCURRED REGARDLESS OF WHETHER THE MEDICAL EMERGENCY WAS CAUSED BY THE RECKLESSNESS, GROSS NEGLIGENCE OR NEGLIGENCE OF A HEAD GUIDE, ASSISTANT GUIDE OR INTERN.

Outdoor Adventures Club cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending any and all Events could increase your risk and your child(ren)’s risk of contracting COVID-19. BY SIGNING THIS AGREEMENT, I ACKNOWLEDGE THE CONTAGIOUS NATURE OF COVID-19 AND VOLUNTARILY ASSUME THE RISK THAT MY CHILD(REN) AND I MAY BE EXPOSED TO OR INFECTED BY COVID-10 BY ATTENDING EVENTS AND THAT SUCH EXPOSURE OR INFECTION MAY RESULT IN PERSONAL INJURY, ILLNESS, PERMANENT DISABILITY AND DEATH.

I acknowledge that this Accident Waiver and Release of Liability Form will be used by Outdoor Adventures Club and any other event holders, sponsors, and/or organizers of the Activity or Event in which I may participate, and that it will govern my actions and responsibilities at said Activity or Event.

IN CONSIDERATION OF MY APPLICATION AND PERMITTING ME TO PARTICIPATE IN THIS EVENT, I HEREBY TAKE ACTION FOR MYSELF, MY HEIRS, SPOUSES, EXECUTORS, ADMINISTRATORS, TRUSTORS, TRUSTEES, BENEFICIARIES, PREDECESSORS, SUCCESSORS, ASSIGNS, PARTNERS, PARTNERSHIPS, PARENTS, SUBSIDIARIES, AFFILIATED AND RELATED ENTITIES, OFFICERS, DIRECTORS, BOARD MEMBERS, COUNCIL MEMBERS, PRINCIPALS, AGENTS, EMPLOYEES, SERVANTS, REPRESENTATIVES, SHAREHOLDERS, AND ALL PERSONS, FIRMS, ASSOCIATIONS, DISTRICTS, AGENCIES, AND/OR CORPORATIONS CONNECTED WITH THEM, INCLUDING WITHOUT LIMITATION THEIR THIRD PARTY ADMINISTRATORS, TRUSTEES, INSURANCE CARRIERS, ATTORNEYS, AGENTS, CONSULTANTS, REPRESENTATIVES, EXPERTS AND RELATED ENTITIES:

I WAIVE, RELEASE, AND DISCHARGE OUTDOOR ADVENTURES CLUB, INCLUDING ITS FORMER AND PRESENT AFFILIATED ENTITIES, JOINT VENTURERS, PARTNERSHIPS, PARTNERS, TRUSTEES, BENEFICIARIES, PREDECESSORS, SUCCESSORS, MANAGERS, MANAGING AGENTS, OFFICERS, DIRECTORS, SHAREHOLDERS, EMPLOYEES, AGENTS, REPRESENTATIVES, ASSIGNS, DESIGNERS, ENGINEERS, ARCHITECTS, CONTRACTORS, SUBCONTRACTORS, MATERIAL SUPPLIERS, SURETIES, INSURANCE BROKERS, THIRD PARTY ADMINISTRATORS, INSURANCE CARRIERS, ATTORNEYS, SALES AGENTS, CONSULTANTS, REPRESENTATIVES, VOLUNTEERS, THE ACTIVITY OR EVENT HOLDERS, ACTIVITY OR EVENT SPONSORS, ACTIVITY OR EVENT VOLUNTEERS AND RELATED ENTITIES FROM ANY AND ALL LIABILITY, INCLUDING BUT NOT LIMITED TO, LIABILITY ARISING FROM THE WILLFUL MISCONDUCT, GROSS NEGILIGENCE, NEGLIGENCE, RECKLESSNESS OR FAULT OF THE ENTITIES OR PERSONS RELEASED, FOR MY DEATH, DISABILITY, PERSONAL INJURY, PROPERTY DAMAGE, PROPERTY THEFT, OR ACTIONS OF ANY KIND WHICH MAY HEREAFTER OCCUR TO ME INCLUDING MY TRAVELING TO AND FROM THIS ACTIVITY OR EVENT AND THE TRAININGS THERETO.

I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE THE ENTITIES OR PERSONS MENTIONED ABOVE IN THIS RELEASE FROM ANY AND ALL LIABILITIES OR CLAIMS MADE AS A RESULT OF PARTICIPATION IN THIS ACTIVITY OR EVENT, WHETHER CAUSED BY THE WILLFUL MISCONDUCT, GROSS NEGILIGENCE, NEGLIGENCE, RECKLESSNESS OR FAULT OF THE ENTITIES OR PERSONS RELEASED OR OTHERWISE.

I ACKNOWLEDGE THAT OUTDOOR ADVENTURES CLUB AND ITS FORMER AND PRESENT AFFILIATED ENTITIES, JOINT VENTURERS, PARTNERSHIPS, PARTNERS, TRUSTEES, BENEFICIARIES, PREDECESSORS, SUCCESSORS, MANAGERS, MANAGING AGENTS, OFFICERS, DIRECTORS, SHAREHOLDERS, EMPLOYEES, AGENTS, REPRESENTATIVES, ASSIGNS, DESIGNERS, ENGINEERS, ARCHITECTS, CONTRACTORS, SUBCONTRACTORS, MATERIAL SUPPLIERS, SURETIES, INSURANCE BROKERS, THIRD PARTY ADMINISTRATORS, INSURANCE CARRIERS, ATTORNEYS, SALES AGENTS, CONSULTANTS, REPRESENTATIVES, VOLUNTEERS, THE ACTIVITY OR EVENT HOLDERS, ACTIVITY OR EVENT SPONSORS, ACTIVITY OR EVENT VOLUNTEERS AND RELATED ENTITIES ARE NOT RESPONSIBLE FOR THE ERRORS, OMISSIONS, ACTS, OR FAILURES TO ACT OF ANY PARTY OR ENTITY CONDUCTING A SPECIFIC EVENT OR ACTIVITY ON BEHALF OF THE OUTDOOR ADVENTURES CLUB.

I ACKNOWLEDGE THAT THIS ACTIVITY OR EVENT MAY INVOLVE A TEST OF A PERSON’S PHYSICAL AND MENTAL LIMITS AND MAY CARRY WITH IT THE POTENTIAL FOR DEATH, SERIOUS INJURY, AND PROPERTY LOSS. THE RISKS MAY INCLUDE, BUT ARE NOT LIMITED TO, THOSE CAUSED BY TERRAIN, FACILITIES, TEMPERATURE, WEATHER, CONDITION OF PARTICIPANTS, EQUIPMENT, VEHICULAR TRAFFIC, ACTIONS OF OTHER PEOPLE INCLUDING, BUT NOT LIMITED TO, PARTICIPANTS, VOLUNTEERS, SPECTATORS, COACHES, EVENT OFFICIALS, AND EVENT MONITORS, AND/OR PRODUCERS OF THE EVENT, AND LACK OF HYDRATION. THESE RISKS ARE NOT ONLY INHERENT TO PARTICIPANTS, BUT ARE ALSO PRESENT FOR VOLUNTEERS.

I hereby consent to receive medical treatment which may be deemed advisable in the Event of injury, accident, and/or illness during this Activity or Event.

I hereby give Outdoor Adventures Club the right to interview and/or to take photographs, audio or audio-visual recordings of me to be used in promotional, educational or fundraising materials including, but not limited to videotapes, pamphlets and brochures. I understand my name may be used in connection with these materials. By signing this media release, I intend to legally bind myself, my heirs, executors and administrators. Outdoor Adventures Club shall have the right to use photographs or other images of me in promotion, educational or fund-raising materials. I acknowledge that Outdoor Adventures Club shall have all rights of copyright in and to such photographs and videotapes and may use such copyright fully. I also hereby release Outdoor Adventures Club and its officers, agents and employees from all liability connected with the taking and use of these materials as is authorized by Outdoor Adventures Club. In addition, I waive all rights, interest or claims for payment in connection with any exhibition or release of these materials. This consent is voluntary, and I give it in the interest of public information, education, the furtherance of the goals of these institutions, or other lawful purposes. I acknowledge that I have legal authority to sign this form on behalf of the minor whose name is mentioned above.

The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under Texas law, which shall be the governing law.

I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT, AND I SIGN IT OF MY OWN FREE WILL. THE UNDERSIGNED ARE HEREBY WAIVING NEGLIGENCE CLAIMS, GROSS NEGLIGENCE CLAIMS, PERSONAL INJURY CLAIMS AND MENTAL ANGUISH CLAIMS.

IN ADDITION:

I HAVE READ THE OUTDOOR ADVENTURES VOLUNTEER POLICY HANDBOOK

I Agree

BY SIGNING BELOW, I AGREE TO THE FOLLOWING:

1.     I AGREE WITH THE STATEMENT OF FAITH SET FORTH IN THE VOLUNTEER POLICY HANDBOOK;

2.     I AGREE THAT I WILL AT ALL TIMES DURING THE COURSE OF MY WORK WITH OUTDOOR ADVENTURES CLUB COMPLY WITH THE FOLLOWING CHILD PROTECTION CODE OF CONDUCT:

·       NOT ENGAGE CHILDREN IN ANY FORM OF SEXUAL ACTIVITY OR ACTS, INCLUDING PAYING FOR SEXUAL SERVICES OR ACTS, WHERE UNDER THE LAW(S) APPLICABLE IN UNITED STATES, THE CHILD IS BELOW THE AGE OF CONSENT OR THE ACTS ARE AN OFFENSE UNDER RELEVANT LAWS;

·       NOT SLEEP IN THE SAME BED AS A CHILD UNLESS ABSOLUTELY NECESSARY, IN WHICH CASE I MUST OBTAIN MY SUPERVISOR’S PERMISSION, AND ENSURE THAT ANOTHER ADULT IS PRESENT.

·       USE ANY COMPUTERS, MOBILE PHONES, OR VIDEO AND DIGITAL CAMERAS APPROPRIATELY, AND NEVER TO EXPLOIT OR HARASS CHILDREN OR TO ACCESS CHILD PORNOGRAPHY THROUGH ANY MEDIUM;

·       NOT ENGAGE IN 1/1 MESSAGING WITH AN OUTDOOR ADVENTURES’ MINOR OF THE OPPOSITE SEX;

·       REFRAIN FROM EVER USING SNAP CHAT WITH OUTDOOR ADVENTURES’ MINORS AND FROM EVER DELETING MESSAGES BETWEEN AN OUTDOOR ADVENTURES’ CHILD AND YOU;

·       REFRAIN FROM PHYSICAL PUNISHMENT OR DISCIPLINE OF CHILDREN;

·       TREAT CHILDREN WITH RESPECT REGARDLESS OF RACE, COLOR, LANGUAGE, ETHNICITY, OR POLITICAL STATUS;

·       NOT USE LANGUAGE OR BEHAVIOR TOWARDS CHILDREN THAT IS INAPPROPRIATE, HARASSING, ABUSIVE, SEXUALLY PROVOCATIVE, DEMEANING OR CULTURALLY INAPPROPRIATE;

·       WHENEVER POSSIBLE, ENSURE THAT ANOTHER ADULT IS PRESENT WHEN WORKING IN THE PROXIMITY OF CHILDREN; AND

·       IMMEDIATELY REPORT CONCERNS OR ALLEGATIONS OF CHILD ABUSE IN ACCORDANCE WITH APPROPRIATE PROCEDURES.

3.     I AGREE TO ADHERE TO ALL POLICIES SET FORTH IN THE VOLUNTEER POLICY HANDBOOK.




First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Do you have a medical condition? If you are currently under a doctor's care for something, then the answer should be YES. Medical conditions include conditions such as diabetes, asthma, heart problems, lung disease, seizures, epilepsy, migraines, IBS or celiac disease, allergies and sleep disorders, such as sleep walking.*

If you have a medical condition or are under a doctor's care for something, what is it? And, if so, what medications, do you take? If you do NOT write in a response, then it is assumed that you do NOT have a medical condition, and it is assumed that you do NOT take any medications.

If you have a medication allergy or a food allergy, list your allergies here. If you do NOT write in a response, then it is assumed that you are stating that you do NOT have any allergies.
Are you healthy enough and physically capable (without medical risk involved) to backpack (strenuous hiking with a heavy pack) at a high altitude? *
Yes
No
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Do you have a medical condition? If you are currently under a doctor's care for something, then the answer should be YES. Medical conditions include conditions such as diabetes, asthma, heart problems, lung disease, seizures, epilepsy, migraines, IBS or celiac disease, allergies and sleep disorders, such as sleep walking.*

If you have a medical condition or are under a doctor's care for something, what is it? And, if so, what medications, do you take? If you do NOT write in a response, then it is assumed that you do NOT have a medical condition, and it is assumed that you do NOT take any medications.

If you have a medication allergy or a food allergy, list your allergies here. If you do NOT write in a response, then it is assumed that you are stating that you do NOT have any allergies.
Are you healthy enough and physically capable (without medical risk involved) to backpack (strenuous hiking with a heavy pack) at a high altitude? *
Yes
No
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Do you have a medical condition? If you are currently under a doctor's care for something, then the answer should be YES. Medical conditions include conditions such as diabetes, asthma, heart problems, lung disease, seizures, epilepsy, migraines, IBS or celiac disease, allergies and sleep disorders, such as sleep walking.*

If you have a medical condition or are under a doctor's care for something, what is it? And, if so, what medications, do you take? If you do NOT write in a response, then it is assumed that you do NOT have a medical condition, and it is assumed that you do NOT take any medications.

If you have a medication allergy or a food allergy, list your allergies here. If you do NOT write in a response, then it is assumed that you are stating that you do NOT have any allergies.
Are you healthy enough and physically capable (without medical risk involved) to backpack (strenuous hiking with a heavy pack) at a high altitude? *
Yes
No
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Do you have a medical condition? If you are currently under a doctor's care for something, then the answer should be YES. Medical conditions include conditions such as diabetes, asthma, heart problems, lung disease, seizures, epilepsy, migraines, IBS or celiac disease, allergies and sleep disorders, such as sleep walking.*

If you have a medical condition or are under a doctor's care for something, what is it? And, if so, what medications, do you take? If you do NOT write in a response, then it is assumed that you do NOT have a medical condition, and it is assumed that you do NOT take any medications.

If you have a medication allergy or a food allergy, list your allergies here. If you do NOT write in a response, then it is assumed that you are stating that you do NOT have any allergies.
Are you healthy enough and physically capable (without medical risk involved) to backpack (strenuous hiking with a heavy pack) at a high altitude? *
Yes
No
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Do you have a medical condition? If you are currently under a doctor's care for something, then the answer should be YES. Medical conditions include conditions such as diabetes, asthma, heart problems, lung disease, seizures, epilepsy, migraines, IBS or celiac disease, allergies and sleep disorders, such as sleep walking.*

If you have a medical condition or are under a doctor's care for something, what is it? And, if so, what medications, do you take? If you do NOT write in a response, then it is assumed that you do NOT have a medical condition, and it is assumed that you do NOT take any medications.

If you have a medication allergy or a food allergy, list your allergies here. If you do NOT write in a response, then it is assumed that you are stating that you do NOT have any allergies.
Are you healthy enough and physically capable (without medical risk involved) to backpack (strenuous hiking with a heavy pack) at a high altitude? *
Yes
No
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Do you have a medical condition? If you are currently under a doctor's care for something, then the answer should be YES. Medical conditions include conditions such as diabetes, asthma, heart problems, lung disease, seizures, epilepsy, migraines, IBS or celiac disease, allergies and sleep disorders, such as sleep walking.*

If you have a medical condition or are under a doctor's care for something, what is it? And, if so, what medications, do you take? If you do NOT write in a response, then it is assumed that you do NOT have a medical condition, and it is assumed that you do NOT take any medications.

If you have a medication allergy or a food allergy, list your allergies here. If you do NOT write in a response, then it is assumed that you are stating that you do NOT have any allergies.
Are you healthy enough and physically capable (without medical risk involved) to backpack (strenuous hiking with a heavy pack) at a high altitude? *
Yes
No
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Do you have a medical condition? If you are currently under a doctor's care for something, then the answer should be YES. Medical conditions include conditions such as diabetes, asthma, heart problems, lung disease, seizures, epilepsy, migraines, IBS or celiac disease, allergies and sleep disorders, such as sleep walking.*

If you have a medical condition or are under a doctor's care for something, what is it? And, if so, what medications, do you take? If you do NOT write in a response, then it is assumed that you do NOT have a medical condition, and it is assumed that you do NOT take any medications.

If you have a medication allergy or a food allergy, list your allergies here. If you do NOT write in a response, then it is assumed that you are stating that you do NOT have any allergies.
Are you healthy enough and physically capable (without medical risk involved) to backpack (strenuous hiking with a heavy pack) at a high altitude? *
Yes
No
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Do you have a medical condition? If you are currently under a doctor's care for something, then the answer should be YES. Medical conditions include conditions such as diabetes, asthma, heart problems, lung disease, seizures, epilepsy, migraines, IBS or celiac disease, allergies and sleep disorders, such as sleep walking.*

If you have a medical condition or are under a doctor's care for something, what is it? And, if so, what medications, do you take? If you do NOT write in a response, then it is assumed that you do NOT have a medical condition, and it is assumed that you do NOT take any medications.

If you have a medication allergy or a food allergy, list your allergies here. If you do NOT write in a response, then it is assumed that you are stating that you do NOT have any allergies.
Are you healthy enough and physically capable (without medical risk involved) to backpack (strenuous hiking with a heavy pack) at a high altitude? *
Yes
No
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Do you have a medical condition? If you are currently under a doctor's care for something, then the answer should be YES. Medical conditions include conditions such as diabetes, asthma, heart problems, lung disease, seizures, epilepsy, migraines, IBS or celiac disease, allergies and sleep disorders, such as sleep walking.*

If you have a medical condition or are under a doctor's care for something, what is it? And, if so, what medications, do you take? If you do NOT write in a response, then it is assumed that you do NOT have a medical condition, and it is assumed that you do NOT take any medications.

If you have a medication allergy or a food allergy, list your allergies here. If you do NOT write in a response, then it is assumed that you are stating that you do NOT have any allergies.
Are you healthy enough and physically capable (without medical risk involved) to backpack (strenuous hiking with a heavy pack) at a high altitude? *
Yes
No
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Do you have a medical condition? If you are currently under a doctor's care for something, then the answer should be YES. Medical conditions include conditions such as diabetes, asthma, heart problems, lung disease, seizures, epilepsy, migraines, IBS or celiac disease, allergies and sleep disorders, such as sleep walking.*

If you have a medical condition or are under a doctor's care for something, what is it? And, if so, what medications, do you take? If you do NOT write in a response, then it is assumed that you do NOT have a medical condition, and it is assumed that you do NOT take any medications.

If you have a medication allergy or a food allergy, list your allergies here. If you do NOT write in a response, then it is assumed that you are stating that you do NOT have any allergies.
Are you healthy enough and physically capable (without medical risk involved) to backpack (strenuous hiking with a heavy pack) at a high altitude? *
Yes
No
Parent or Guardian's Email Address

Email*

Confirm Email*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
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*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Do you have a medical condition? If you are currently under a doctor's care for something, then the answer should be YES. Medical conditions include conditions such as diabetes, asthma, heart problems, lung disease, seizures, epilepsy, migraines, IBS or celiac disease, allergies and sleep disorders, such as sleep walking.*

If you have a medical condition or are under a doctor's care for something, what is it? And, if so, what medications, do you take? If you do NOT write in a response, then it is assumed that you do NOT have a medical condition, and it is assumed that you do NOT take any medications.

If you have a medication allergy or a food allergy, list your allergies here. If you do NOT write in a response, then it is assumed that you are stating that you do NOT have any allergies.
Are you healthy enough and physically capable (without medical risk involved) to backpack (strenuous hiking with a heavy pack) at a high altitude? *
Yes
No
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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