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The Pentecostal Assemblies of Canada, BC/Yukon District’s YouthGetaway Conference Release of Liability, Waiver of Claims, Assumption of Risks and Indemnity Agreement  

I, Parent/Guardian, hereby authorise and acknowledge that my child will be participating in Youth Getaway (the Event) organized by The Pentecostal Assemblies of Canada, BC/Yukon District from May 2, 2025 – May 4, 2025. I understand that the Event will involve risks to my child arising out of his/her travelling and participating in various activities and events, including the use of inflatables and participating in a dodgeball tournament. These risks include, but are not limited to the following activities:

Inflatables

  • The event will feature inflatables, including the Adrenaline Bootcamp Obstacle Course, Human Foosball and Hungry Hippo Chow Down.
  • Parents/guardians acknowledge that their child(ren) will use the inflatables during the conference.

Inflatables Use Acknowledgement:

  • By signing this waiver, parents/guardians acknowledge that their child(ren) will use the inflatables at their own risk.

Dodgeball Tournament:

  • The conference includes a Dodgeball Tournament as part of the activities.
  • Participants and parents/guardians are aware of the dodgeball tournament and its associated risks.

Liability Waiver

I, the undersigned parent/guardian of the participant(s) named below, hereby agree to the following terms and conditions:

Please write your initials next to all items to confirm your understanding and agreement.

1. Assumption of Risk:

  • I understand that participation in the Event involves inherent risks, including but not limited to physical injury and possibly death, property damage, and emotional distress.
  • I voluntarily assume, on behalf of me and my child, the full risk and responsibility for any injury, harm or death that my child may suffer arising in any way from my child’s travel to/from and participation in the Event.


2. Release and Waiver:

  • On my own behalf and on behalf of my child, I waive, to the full extent possible at law, any rights whatsoever that I and my child may have now or in the future against The Pentecostal Assemblies of Canada, BC/Yukon District, TBD [Participant’s Church/Youth Group], its affiliated churches and their respective officers, directors, employees, organizers, leaders, volunteers, agents, and sponsors (the “Releasees”) as a result of the death or injury or damage to the my child or my child’s property arising from my child’s travel to/from or participation in the Event;
  • On my own behalf and on behalf of my child, I release and forever discharge the Releasees from any and all actions, causes of actions, suits, claims and demands whatsoever that I or my child may have against any of the Releasees as a result of, arising out of or in any way connected with my child’s travel to/from or participation in the Event.
  • This waiver and release include claims related to negligence, gross negligence, breach of contract, or any other legal theory.


3. Medical Treatment Authorization:

  • I have disclosed all medical conditions and/or allergies from which my child may suffer. 
  • In the event of an emergency, I authorize The Pentecostal Assemblies of Canada, BC/Yukon District, and TBD [Participant’s Church/Youth Group] or its employees and volunteers to seek medical treatment for my child(ren) as necessary.
  • I agree to ensure that at all times my child is covered by medical insurance.
  • I understand that I will be responsible for any medical expenses incurred.


4. Photography and Media Release:

  • I grant permission for The Pentecostal Assemblies of Canada, BC/Yukon District and TBD [Participant’s Church/Youth Group] to use photographs, videos, or other media featuring my child(ren) for promotional purposes.


5. Acknowledgment of Rules:

  • I have read and understood the Event rules and guidelines provided by The Pentecostal Assemblies of Canada, BC/Yukon District and TBD [Participant’s Church/Youth Group]
  • I agree to ensure that my child(ren) comply with these rules.


Release and Indemnity

Having been made aware of the activities the registrant will be participating in, I hereby consent to the registrant’s participation in the BC/Yukon PAOC’s Youth Getaway 2025 conference. I voluntarily release and forever discharge The Pentecostal Assemblies of Canada, BC/Yukon District, TBD [Participant’s Church/Youth Group], and its affiliated churches and their respective officers, directors, employees, organizers, leaders, volunteers, agents, and sponsors (the “Releasees”) from any and all liability, claims, actions, or rights of action which are in any way related to the registrant’s travel to/from and participation in the conference activities. I agree to indemnify and hold the Releasees harmless from any and all costs or damages, including attorney fees, incurred in connection with the registrant’s participation in conference activities. I further agree not to sue, assert or otherwise maintain any claim or cause of action against any of the Releasees arising from or connected with the registrant’s participation in conference activities.

By attending Youth Getaway 2025, you will be participating in an event where photography, video and audio recording may occur. Your attendance and participation in the event signifies your acceptance of this, and releases The Pentecostal Assemblies of Canada, BC/Yukon District and TBD [Participant’s Church/Youth Group] from any liability, payment or royalties in connection with the capture, reproduction or distribution of the images, video or audio by The Pentecostal Assemblies of Canada, BC/Yukon District and TBD [Participant’s Church/Youth Group] as it deems fit.

In case of emergency, I understand every reasonable effort will be made to contact the parents or guardians of minor registrants. However, if the parents or guardians cannot be reached within a reasonable time period under the circumstances, or if I, the below signed registrant am 19 years of age or older, I hereby give The Pentecostal Assemblies of Canada, BC/Yukon District and TBD [Participant’s Church/Youth Group] permission to act on my behalf in seeking and administering medical treatment in the event that such treatment is deemed necessary or advisable for the registrant’s health, safety and welfare. I release The Pentecostal Assemblies of Canada, BC/Yukon District and TBD [Participant’s Church/Youth Group] from liability in acting on my behalf in this regard and rendering such medical treatment. I agree to submit any claims or causes of action regarding the enforceability of this waiver or any claim related to the subject matter herein to the Christian Coalition/mediation organization for binding resolution.

I have read and carefully understand this Release.

Today's Date: April 26, 2025

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Age

Medical Number (Optional):

Allergies:
Will your child be bring medications with him/her?*
No
Yes

If yes, please list:

Participant’s Church/Youth Group *
First Participant's Signature*
Second Participant's Name

First Name*

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

Age

Medical Number (Optional):

Allergies:
Will your child be bring medications with him/her?*
No
Yes

If yes, please list:

Participant’s Church/Youth Group *
Third Participant's Name

First Name*

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

Age

Medical Number (Optional):

Allergies:
Will your child be bring medications with him/her?*
No
Yes

If yes, please list:

Participant’s Church/Youth Group *
Fourth Participant's Name

First Name*

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

Age

Medical Number (Optional):

Allergies:
Will your child be bring medications with him/her?*
No
Yes

If yes, please list:

Participant’s Church/Youth Group *
Fifth Participant's Name

First Name*

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

Age

Medical Number (Optional):

Allergies:
Will your child be bring medications with him/her?*
No
Yes

If yes, please list:

Participant’s Church/Youth Group *
Sixth Participant's Name

First Name*

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

Age

Medical Number (Optional):

Allergies:
Will your child be bring medications with him/her?*
No
Yes

If yes, please list:

Participant’s Church/Youth Group *
Seventh Participant's Name

First Name*

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

Age

Medical Number (Optional):

Allergies:
Will your child be bring medications with him/her?*
No
Yes

If yes, please list:

Participant’s Church/Youth Group *
Eighth Participant's Name

First Name*

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

Age

Medical Number (Optional):

Allergies:
Will your child be bring medications with him/her?*
No
Yes

If yes, please list:

Participant’s Church/Youth Group *
Ninth Participant's Name

First Name*

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

Age

Medical Number (Optional):

Allergies:
Will your child be bring medications with him/her?*
No
Yes

If yes, please list:

Participant’s Church/Youth Group *
Tenth Participant's Name

First Name*

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

Age

Medical Number (Optional):

Allergies:
Will your child be bring medications with him/her?*
No
Yes

If yes, please list:

Participant’s Church/Youth Group *
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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

Age

Medical Number (Optional):

Allergies:
Will your child be bring medications with him/her?*
No
Yes

If yes, please list:

Participant’s Church/Youth Group *
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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