RELEASE OF LIABILITY
A Separate Release Must be Completed for Each Participant
READ CAREFULLY - THIS AFFECTS YOUR LEGAL RIGHTS
In exchange for participation in the activity of Shamanic Medicine Camp organized by the Circle of Earth People, one of The Spence Companies, Inc. ("CEP"), of 595 E. 7th Avenue, Durango, Colorado, 81301 USA and/or use of the property, facilities and services of CEP, I agree for myself or (if applicable) for a member of my family, to the following:
1. I agree to observe and obey all posted rules and warnings, and further agree to follow any oral instructions or directions given by CEP, or the employees, representatives or agents of CEP.
2. I understand that camp conditions can be rigorous including low oxygen availability at camps held at altitude; hiking, climbing and other strenuous activities with minimal breaks; spending time in confined spaces such as caves or sweat lodges; high and low temperatures; exposure to the elements; encounters with wild animals; etc. and that these conditions may cause discomfort and danger to life and limb. I assume full responsibility for personal injury to myself and (if applicable) my family members, and further release and discharge CEP for injury, loss or damage arising out of my or my family's use of or presence upon the facilities of CEP, whether caused by the fault of myself, my family, CEP or other third parties.
3. I agree to indemnify and defend CEP against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my or my family's use of or presence upon the facilities of CEP.
4. I agree to pay for all damages to the facilities of CEP caused by my or my family's negligent, reckless, or willful actions.
5. (Complete if your minor child will be attending unaccompanied by you.) I consent to the participation of my (son/daughter) ____________________, (child's name)____________________________ of (address)__________________________________________________________ ________________________________________________________ in Shamanic Medicine Camp, and agree on behalf of the above minor to all of the terms and conditions of this Agreement.By signing this Release of Liability, I represent that I have legal authority over and custody of(child's name)___________________________________.
6. In the event of an injury to the above minor during the above-described activities, I give my permission to CEP or to the employees, representatives or agents of CEP to arrange for all necessary medical treatment for which I shall be financially responsible. This temporary authority will begin on (enter first day of camp) __________________ and will remain in effect until terminated in writing by the undersigned or when the above-described activities are completed. CEP shall have the following powers:
a. The power to seek appropriate medical treatment or attention on behalf of my child as may be required by the circumstances, including without limitation, that of a licensed medical physician and/or a hospital;
b. The power to authorize medical treatment or medical procedures in an emergency situation; and
c. The power to make appropriate decisions regarding clothing, bodily nourishment and shelter.
7. I or my child, as applicable, have the following medical condition that may impact my/their safety or ability to participate fully in camp activities (write "none" if applicable): ______________________________________________________________________
______________________________________________________________________
8. I or my child, as applicable, am currently taking the following prescription drugs (write "none" if applicable): ______________________________________________________________________
______________________________________________________________________
9. Any legal or equitable claim that may arise from participation in the above shall be resolved under Colorado, USA law.
I HAVE READ THIS DOCUMENT AND UNDERSTAND IT.I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARY SURRENDER CERTAIN LEGAL RIGHTS.
Dated: __________________
Signature: ____________________________________
Name: ____________________________________
Address: ____________________________________
____________________________________
__________________________ _________
In case of an emergency, please call ____________________________ (Relationship: _________________________) at (day) ________________ Ext. ______, or (evening) ________________ Ext. ______.