By checking the box below and submitting this form, I certify that:

I understand that participation in this event is completely voluntary and at the discretion of the Christian Church in GA/Disciples of Christ and Young Adult Disciples Association.

If the adult sponsors from the above church/organization decide to take the youth from the church/organization off the grounds of Epworth by the Sea, I give my permission for my child to go. I understand that the Christian Church (Disciples of Christ) in Georgia is not liable for accidents, injuries, or events that may occur while my child is off the Epworth by The Sea premises.

I agree to all terms voluntarily.

I understand this is a legally binding agreement.

I grant permission to be photographed or recorded for promotional or archival purposes.

I, acknowledge that my participation in Christian Church in Georgia / Disciples of Christ activities involves inherent risks. These activities may include, but are not limited to: outdoor recreation, sports, transportation, group activities, water activities, and other supervised camp programs. I understand that such activities carry risks of injury, illness, or, in rare cases, death.

I voluntarily choose to participate in all retreat activities with full knowledge and acceptance of these risks.

I understand that during this event the adult sponsors from the above named participant’s church/organization will be responsible for the above named participant, for whom I am legally responsible. In case of an emergency, I give my permission for medical treatment to be administered. I grant permission for this individual to participate fully in said trip, and hereby give permission to take this participant to a doctor or hospital, if necessary, and hereby authorize medical treatment, including but not in limitation to emergency surgery or medical treatment. I assume the responsibility of all medical bills, if any are incurred. Further, should it be necessary for the participant to return home due to medical reasons, disciplinary action or otherwise, I will assume transportation costs.