AdventureServe Ministries Program Liability Waiver & Medical Form

For and in consideration of the services of AdventureServe Ministries (sometimes referred to in this document as ASM) the undersigned, for themselves and on behalf of a minor for whom they may sign, acknowledge and agree as follows:

I, a participant or the Parent of a minor participant (on behalf of that minor, for myself, my executors, administrators, heirs and assigns) hereby voluntarily choose to participate (or allow my minor child to participate) in AdventureServe programs. I also voluntary agree to forever release, relieve, surrender, waive, discharge, hold harmless, defend, indemnify, and covenant not to sue ASM and its owners, agents, volunteers, officers, and employees (collectively referred to as “Released Parties”) from any and all liability, claims, actions or losses of any kind or nature, foreseen or unforeseen, known or unknown, whether for personal injury, property damage, wrongful death, loss of services or otherwise, arising out of my, or my child’s, enrollment or participation in a ASM missions or wilderness adventure experience, including transportation to and from any such activities, or use of ASM’s equipment. I specifically understand that I am releasing, discharging and waiving, among others, any claims or actions that I or the minor may have, or acquire, for the negligent acts or other conduct of Released Parties. This release shall be binding to the fullest extent permitted by law. If any part of the release is deemed to be unenforceable, the remaining terms nevertheless shall be enforceable.

AGREEMENTS OF RELEASE AND INDEMNITY

ACKNOWLEDGMENT AND ASSUMPTION OF RISKS

ASM missions, service, and wilderness adventure experiences include a number of activities, including but not limited to camping, challenge course, hiking, caving, backpacking, outdoor and indoor rock-climbing, rappelling, white water rafting, swimming, canoeing, construction repairs, service activities, and other activities specific to a particular program experience. These activities may be physically demanding and I am aware that it may involve hazardous activities and risk of serious personal injury or death. Injuries could include but are not limited to cuts, abrasions, sprains, strains, weather hazards, burns, extreme temperatures, and equipment failure. I, on behalf of myself or my child, am participating voluntarily in these activities with the knowledge and appreciation of the dangers involved and I, on behalf of myself or my child, voluntarily agree to accept and assume all risks of personal injury, death, or any other damages or losses to my person or property. In the event that any claim arising out of or related to personal injury, death, or damage shall be filed against any Released Parties, I shall indemnify and hold harmless Released Parties from and against any and all such claims, including Attorney’s fees, incurred in defense of such claims.

RELEASE OF LIABILITY AND COVENANT NOT TO SUE

In consideration for being allowed to participate in AdventureServe programs, I, on behalf of myself and/or my minor child, and my heirs, executors, administrators, personal representatives, and assigns, hereby:

AdventureServe Ministries, its directors, officers, employees, staff, volunteers, agents, representatives, affiliated churches, property owners, and partnering organizations (collectively referred to as “Released Parties”) from any and all claims, demands, causes of action, damages, losses, liabilities, or expenses, including attorney’s fees, arising out of or related to participation in AdventureServe programs.

This release includes claims based on the alleged negligence of the Released Parties.

  • Waive

  • Release

  • Discharge

  • Hold harmless

  • Defend

  • Indemnify

  • And covenant not to sue

INDEMNIFICATION

If any claim is brought against any Released Party arising from my participation or my minor child’s participation, I agree to indemnify and hold harmless the Released Parties from any loss, liability, damage, or cost, including attorney’s fees.

MEDICAL REPRESENTATION

I affirm that:

  • I (or my minor child) am physically able to participate in AdventureServe activities.

  • All medical information provided to ASM either in writing or verbally is accurate and complete.

  • I understand that participation in physically demanding outdoor/service activities carries inherent risk.

I accept full responsibility for failure to disclose any medical condition that could affect participation.

ASM reserves the right to refuse participation to any person it judges to be incapable of meeting the rigors and requirements of participating in its activities. I therefore represent that the medical and health information I have provided on this form is true and accurate to the best of my knowledge. I accept full responsibility for any omissions and potential consequences regarding my failure to disclose any existing or past health condition. I am, or the minor child is, in good physical condition and therefore fully capable of participating in and able to undertake all of the activities involved in an ASM experience. I, or the minor, do/does not have any medical condition that would prevent my, or his/her, participation in any activities except for those restrictions shared with ASM in writing or verbally.

EMERGENCY MEDICAL AUTHORIZATION

I authorize AdventureServe staff, guides, or designated personnel to:

  • Provide first aid

  • Administer routine, non-prescription medications unless specifically prohibited in writing

  • Seek emergency medical treatment

  • Arrange evacuation if necessary

I understand that some program locations may be remote and that emergency response may be delayed. I agree to assume full financial responsibility for medical treatment rendered, including transportation, evacuation, hospitalization, or other related care beyond any insurance coverage.

INSURANCE ACKNOWLEDGMENT

I understand that AdventureServe carries limited accident and/or general liability coverage.

I acknowledge that I am responsible for maintaining my own health, medical, disability, and life insurance coverage.

CONDUCT EXPECTATIONS

I agree that:

  • Alcohol and illegal drugs are prohibited during AdventureServe programs.

  • I am financially responsible for damage caused by my actions or my minor child’s actions.

  • AdventureServe reserves the right to dismiss participants for unsafe or disruptive behavior without refund.

PHOTO AND MEDIA RELEASE

I grant AdventureServe Ministries and its representatives and agents absolute permission to use photographs, video recordings, audio recordings, written comments, and likenesses of me or my minor child for promotional, marketing, educational, and fundraising purposes without compensation.

SEVERABILITY

I agree that, should there be an issue or dispute as to the validity of any release that I have signed, this document shall supersede any other document that I have read or signed about my legal rights concerning ASM. I also understand that the terms of this agreement shall continue to be in effect even after the trip has ended.

GOVERNING LAW AND VENUE

This Agreement shall be governed by and interpreted under the laws of the Commonwealth of Kentucky.

Any legal action arising out of participation in AdventureServe programs shall be brought exclusively in a court of competent jurisdiction located in Jessamine County, Kentucky.

ACKNOWLEDGMENT OF UNDERSTANDING

I certify that I have read the above statements and understand all the terms of this agreement. I am voluntarily executing the agreement with full knowledge of its significance on behalf of myself, my child or ward and my/my child's assignees, heirs, next of kin, executors, and personal representatives. I am aware that I am releasing certain legal rights that I, or the minor, otherwise may have. No oral representations statements or inducements apart from those contained in this agreement have been made.

My signature below confirms that I have disclosed to program staff any pertinent medical reasons that may affect my safety or the safety of others during this program. In addition, according to my specific limitations, I agree to retain the right and responsibility to choose and direct my own level of participation.