Faith-Based Retreat Excursion Waiver

Participant Information

Full Name Date of Birth Phone Number Email Address Home Address

Emergency Contact

Contact Name Relationship Phone Number

Medical Information

Please list any allergies or medical conditions Medication Currently Taken

Waiver & Release of Liability

I acknowledge that my participation in the faith-based retreat excursion is voluntary and that I assume all risks associated with my involvement, including but not limited to personal injury, illness, or property damage. I release the organizers, leaders, and sponsors from any liability for any damage or injury that may occur during the event. I understand that it is my responsibility to disclose any relevant medical information, and that I am responsible for my own health and safety during the retreat.

By signing below, I indicate that I have read, understood, and agree to the terms outlined above.

Participant Signature Date

If participant is under 18 years of age, a parent or guardian must complete the following:

Parent/Guardian Name Parent/Guardian Signature Date