Volunteer Release Form - Camp Bandina

Name*
Email address*
Cell Phone*
Phone*
Consent*
I will be attending Bandina Christian Youth Camp, Inc. (hereafter referred to as “Bandina”, and asfurther defined below) on the dates listed above. At all times when I have at Bandina I acknowledgethat I will be under the direct supervision of the group listed above (herein known as the “SponsoringOrganization”).
Consent*
I, for myself and/or my heirs, personal representatives and assigns, do hereby release, waive,indemnify, and discharge Bandina, its owners, board of directors, partners, officers, agents,representatives, session directors, volunteers and employees, from LIABILITY from ANY and ALLclaims resulting in personal injury, accidents, or illnesses (including death), and property loss arisingfrom, but not limited to Bandina’s negligence, my actions, and/or the actions taken by my SponsoringOrganization while I am at Bandina, and I further hereby covenant not to sue Bandina or its owners,board of directors, partners, officers, agents, representatives, session directors, volunteers andemployees for any such claim.
Consent*
I, for myself, agree to indemnify and HOLD HARMLESS Bandina and its owners, board of directors,partners, officers, agents, representatives, session directors, volunteers and employees from any andall claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’sfees brought by me or any other person or entity as a result of Bandina’s negligence, my actions,and/or the actions taken by my Sponsoring Organization while I am at Bandina, and I agree toreimburse Bandina and its owners, board of directors, partners, officers, agents, representatives,session directors, volunteers and employees, as applicable, for any such expenses incurred.
Consent*
I authorize Bandina to make arrangements for, or give any medical attention to me as Bandinadeems necessary under the circumstances, at the sole discretion of Bandina. I also give permissionto any medical care providers summoned by Bandina, including every doctor or other medicalprofesion, to hospitalize me and/or secure such other medical treatment as Bandina and the medicalprofessional deem appropriate. I further understand that emergency medical treatment may bedifficult to obtain, and in some instances appropriate treatment ay be delayed because Bandina islocated in a country setting miles away from medial facilities and/or hospital. I release, waive,indemnify and hold harmless Bandina from any harm that is occasioned me due to any delay intreatment of a medical condition.
Consent*
I understand, and agree to assume all risks which I may encounter while at Bandina, includingactivities preliminary to my visit, while at Bandina and subsequent thereto. I understand and assumeall risks for activities I engage in while a guest at Bandina, recognizing and acknowledge that may ofthese activities that I undertake at Bandina have inherent danger, such as swimming in the river,hiking, shooting bows and arrows, softball, volleyball, basketball and other such related activities. Irelease, waive, indemnify and hold harmless Bandina, their owners, board of directors, partners,officers, agents, representatives, session directors, volunteers and employees collectively as “Bandina” or “Indemnified Parties”) from and against all liability, damages, causes ofaction, claims, losses and/or expenses, including but not limited to attorney’s fees, court costs andexpenses, medical costs, and like expenses, which may be related to any injury or death to me, orany person related to me. I also release, indemnify and hold harmless Bandina, and the IndemnifiedParties from any loss or damage to property, including loss of use thereof, caused in whole or in partby Bandina or the Sponsoring Organization, whether such loss was caused in whole or in part bynegligence of the Indemnified Parties, or any one or more of them. This release, however, will notapply in the event of willful misconduct.
Consent*
I further give my permission and consent to Bandina to use any photograph, or video take of mewhile at Bandina for any purpose. I also give my permission to Bandina to use any interview of me,which is reduced to writing, or kept in an audio recording, using whatever platform. Such photograph,videos and/or audio recording may be published by Bandina for the purpose of illustrating Bandina,reporting on Bandina activities, or for the purpose of promoting and advertizing Bandina. Mypermission extends to Bandina to use photographs, videos or audio recordings of my however theysee fit in every kind of media, including, but not limited to, print media, broadcast media, and on theinternet, Facebook, Twitter and any other website based platform that is used by Bandina to reporton Bandina to the general public, and/or for internal purposes – including training. I assign fullcopyright authority to Bandina for photographs, videos or audio recordings of me and claim nointerest in the reproduction of these media resources either wholly or in part. I agree thatphotographs, videos and/or audio recordings can be used separately, or together, whole or in part, inany medium a the sole discretion of Bandina.
Consent*
Should any dispute arise from this agreement, I agree to first seek to mediate such dispute in goodfaith with a qualified mediator acceptable to Bandina and me. Should we not be able to agree on amediator, I agree that the Senior District Judge in Bandera County, Texas will appoint a mediator tomediate the dispute. I also agree that venue for any dispute, or cause of action, arising by andbetween the parties, whether arising out of this agreement or otherwise, can only be brought in acourt of competent jurisdiction in Bandera County, Texas, exclusively, and exclusive of anyprovisions relating to conflict of laws.
Consent*
I expressly agree that this release, waiver, indemnity and hold harmless agreement is intended to bebroad and inclusive as permitted by the law of the State of Texas and that if any portion thereof isheld invalid, I agree that the balance of this agreement shall, notwithstanding, continue in full forceand legal effect. I also agree that in the event I take any legal action against Bandina, which isdecided in favor of Bandina, I agree to be responsible for all legal fees, court costs and out of pocketexpenses incurred by Bandina. This release, waiver, indemnity and hold harmless agreement is theentire agreement by and between the parties hereto and the terms of this release, waiver, indemnityand hold harmless agreement are contractual and not merely a recital
Consent*
I further state that I have carefully read the forgoing, I have ben given full opportunity to consult withan attorney of my choosing, and having done so I sign this release, waiver, indemnity and holdharmless agreement as my own free act. I acknowledge that his is a legally binding document,which I have read, understood and accept to be fully bound by from and on the date of the signing ofthis agreement and thereafter.
Signature*
Date*
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