Crossroads Summer Camp Terms & Medical Release Form

Registering for CRSC22 | North Rock Hill Church - 06/27/2022 12:00 PM - 07/01/2022 10:30 AM Change

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Crossroads Summer Camp
Terms & Conditions

Please read the entire policy below carefully before signing. You (and your parents/guardians, if you are under 18,) will be responsible for its contents. This is important information that affects your and others' experience at Crossroads Summer Camp. 

 

PARTICIPANT INFORMATION

Clayton King Ministries is hosted each summer by a host University. Please submit the following information (found below) of each attendee for your host University to effectively track and annually report the number of CKM event participants expressing interest in, visiting campus, and/or enrolling in your host University:

 

I am open to tracking, but would like to opt out of any promotional mail outs by my host University.

 

CONDUCT AGREEMENT

Everyone attending camp is responsible to read all rules in the Participant Guide prior to arriving at Camp. Participants will be asked to leave at their own expense if they break any listed rule. They will also be responsible for the cost of any and all damages.

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PROMOTIONAL USE CONSENT

I hereby grant explicit consent to Clayton King Ministries' use of my photography (whether by video or photo) and likeness in social media, print media, presentations, websites, solicitations and the like. I waive any right or claim to financial consideration or any other benefits from the use of this material by Clayton King Ministries, Inc. 

I hereby grant explicit consent for any written quotes by myself or my child that are submitted on any evaluation or advisory materials to be used in any digital, print, audio (by a reader), or video (by an actor or reader) that Clayton King Ministries produces for the purpose of promotion, historical documentation, or solicitation of any kind. I waive any right or claim to financial consideration or any other benefits from the use of this material by Clayton King Ministries, Inc. 

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Crossroads Summer Camp
Medical & Liability Release Form

WHEREAS, My child/I wish(es) to attend Crossroads Summer Camp in Anderson, SC (for June 20-24, June 27-July 1, July 11-15, July 17-21) or Gardner-Webb University (July 22-26), a subsidiary of Clayton King Ministries, Inc. (hereafter known as Crossroads), and whereas, certain circumstances may occur resulting in my child's/my need for medical/dental care and treatment, and further resulting in my inability to give consent for such care and treatment; THEREFORE, in consideration of permission from Crossroads for my child/myself to participate in said Summer Camp,

I, being of legal age, authorize Crossroads or any designated agent of Crossroads, to act on my child's/my behalf and to consent to all medical/dental care and treatment, including but not limited to diagnostic tests, x-ray examinations, anesthesia, surgery, or other procedures which Crossroads, on the advice of medical providers, deems necessary for my child's/my medical well being while attending the camp.

In case of accident* or sickness, I consent to emergency medical care provided by ambulance or hospital personnel. This consent is given in advance of any special diagnosis, treatment, surgery, or hospital care required and also for the administration of any over the counter medications including but not limited to Tylenol, Advil, allergy medications, and is given to provide authorization and specific consent for medical/dental treatment and care in my child's/my behalf. Any consent by Crossroads shall have the same force and effect as if I had personally given the consent. 

HEALTH INSURANCE

The participant is covered under active health insurance.

The participant does NOT have active health insurance.

I certify that if I have indicated that I carry an active health insurance policy for all participant(s) in Summer Camp, that it will remain in force during the entire duration of the event for which I am registering and will be considered as the primary insurance policy covering the participant(s).

CONSENT FOR MEDICAL TREATMENT & LIABILITY RELEASE

I hereby release Crossroads, its agents, servants, employees and assigns for any and all damages, liability or costs resulting from the authorizing of medical treatment on my child/my behalf under the terms of the consent. I further hold Crossroads harmless and agree to indemnify Crossroads for any and all costs, damages, or expenses incurred by Crossroads as a result of any claim or action filed by any party alleging damages incurred and as result of any medical treatment provided or authorization for treatment provided. 

I hereby release and hold harmless Clayton King Ministries, its officers, employees, and representatives/volunteers from all liability for personal injury, including death as well as property damage or loss arising out of my child's/my participation in this event. I have read and understand the information above. The information I have given Crossroads is accurate and true to the best of my knowledge. 
 

*Definition of Accident: An unexpected, sudden and definable event which is the direct cause of a bodily injury, independent of any illness, prior injury or congenital predisposition. Conditions that result from participating in an activity do not necessarily constitute accidents. For example, illnesses, diseases, degeneration, conditions caused by continued stress to a particular area of the body, and existing conditions aggravated by an accident may not be covered.

 

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Signee Information

By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.