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URBAN WILDERNESS PROGRAM

AGREEMENT OF PARTICIPATION AND RELEASE OF LIABILITY

Please read carefully and sign below if you agree to all terms.

I recognize that there is an element of risk in any program activity associated with an outdoors organization and I voluntarily assume that risk. Knowing the inherent risks and rigors involved, I certify that I am fully capable of participating in the Urban Wilderness Program (“UWP”), and the Camping & Education Foundation (“CEF”) activities; these activities include, but are not limited to, fire building, cooking, canoeing, fishing, and the use of sharp tools. I also acknowledge that this will be done as a voluntary participant. In consideration of UWP providing the activities, I hereby release any claims for bodily injury, personal injury or property damage, arising out of ordinary negligence, against the UWP and/or CEF, including its agents, employees, directors, officers, and other volunteers. I also release such claims arising out of any act by anyone not under the control of UWP and CEF. I give permission to UWP and CEF to use photographs of me taken during the program, for promotional purposes.

I have read, understand, and accept the terms and conditions stated herein and acknowledge that this agreement shall be effective and binding upon me during the entire period of participation in the Urban Wilderness Program and Camping & Education Foundation activities.

If I am a student, by signing below, my parent or legal guardian makes this certification and provides this release on my behalf.

Students may not participate without a signed waiver. Please sign below.

We are thrilled to offer this opportunity to your students and school community. Please direct all questions and volunteer inquiries to Madlen Anderson, Outdoor Program Coordinator, at madlen@campingedu.org.

3515 MICHIGAN AVENUE • CINCINNATI, OH 45208 • (513) 772-7479 • URBANWILDERNESSPROGRAM.ORG

May 4, 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*

Confirm Email*
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*
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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