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Lakeview Methodist Conference Center 
Program Activities Release and Waiver

Disclosure

Program Activities at Lakeview Methodist Conference Center offer individuals the opportunity to participate in a variety of orientations, games, group initiatives, and personal actions including, but not limited to low & high ropes course elements, zip line, paintball, skeet shoot, sporting activities, gaga ball, dodge ball, archery, crate stacking, axe throwing, jump pillow, etc. – which are all physical activities. Understanding that any physical activity involves the risk of increased heart rate, injury and/or death, I understand that my participation in Program Activities with Lakeview Methodist Conference Center is entirely voluntary and I have the right not to participate. Lakeview Methodist Conference Center reserves the right to deny anyone participation in its Program Activities.

Release of Liability

As evidenced by my signature on this release and waiver, I have read and I understand the above disclosure statement. I and my family release Lakeview Methodist Conference Center, its employees, staff and other agents from any claims or liability arising out of my participation in Program Activities of Lakeview Methodist Conference Center. I understand that Lakeview’s Program Activities may be physically and/or emotionally demanding. I affirm that I have no physical or emotional limitations that might put me or others at risk during my participation in any of the activities except for the following (all such physical or emotional limitations must be listed): TBD

Media Release

As evidenced by my signature on this Release and Waiver, I authorize Lakeview Methodist Conference Center to photograph or permit other persons to photograph, record, conduct media interviews and/or publish information, sounds and images obtained of me, or my minor child herein, while participating at Lakeview Methodist Conference Center. I hereby permit such images and recorded sounds to be disseminated, published or broadcast through any medium Lakeview Methodist Conference Center chooses, including, but not limited to, print, video, DVD, television, radio, social media, digital media, and/or the Internet. I agree that Lakeview Methodist Conference Center may use, reproduce and sell such information, sounds, and images for such purposes and in such manner as they may deem appropriate. I agree that Lakeview Methodist Conference Center may permit others to use such information, sounds and images for such purposes and in such manner as they may deem appropriate. I understand and agree that such dissemination, publication, or broadcast may reveal my or my child’s identity. I agree that the material may be used for any purpose by Lakeview Methodist Conference Center and its successors and assigns, harmless from and against any claim for injury or compensation resulting from the activities authorized above. This authorization has been voluntarily agreed to by me, and/or parent and next friend of minor child herein, and is binding on my heirs, beneficiaries and personal representatives.

Today's Date: May 20, 2025

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

All such physical or emotional limitations must be listed:
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Second Participant's Information

All such physical or emotional limitations must be listed:
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Information

All such physical or emotional limitations must be listed:
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Information

All such physical or emotional limitations must be listed:
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Information

All such physical or emotional limitations must be listed:
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Information

All such physical or emotional limitations must be listed:
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Information

All such physical or emotional limitations must be listed:
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Information

All such physical or emotional limitations must be listed:
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Information

All such physical or emotional limitations must be listed:
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Information

All such physical or emotional limitations must be listed:
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
Parent or Guardian's Information

All such physical or emotional limitations must be listed:
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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