I, the undersigned parent(s)/guardians, hereby give my permission for my child/self (known as "participant") to participate in Dynamos ("activity"), organized by the Gulf Atlantic Diocese. I hereby release hold harmless and absolve GAD, their officers, staff, sponsors, vendors, and all others who have participated in the planning, organizing and implementing of the activity, be they individuals or organizations, singly or collectively, from responsibility and liability for any illness, injury, misadventure, harm, loss or inconvenience suffered or sustained as a result of the participation during camp.

I understand that in the event the participant requires medical treatment while engaged in the activity, reasonable efforts will be made to contact the designated emergency contacts; however, if they cannot be reached, I hereby conset and give my permission to the GAD staff or any adult counselor acting on behalf of GAD with respect to the activity, to consent to any X-ray examination, medical, dental or surgical diagnosis; treatment; and hospital care advised and supervised by a physician, surgeon or dentist (as appropriate) licensed to practice under the laws of the state where the services are rendered, either as an outpatient or in any hospital.

To the best of my knowledge, I have listed all medical allergies, medications being taken, medical problems and other pertinent information. I hereby represent that the participant has the experience and is physically and mentally capable to engage in event activities, and further represent that the participant has no physical or mental limitations to prevent them from engaging in the activities. Participation in this activity may expose the participant to risk of personal injury and damage to his/her property.

In exchange for GAD allowing the participant to engage in the activity, I agree that (a) GAD, its members, ministers, board, agents, and employees will not be liable to me/us for any injury to the participant, his/her property, or my/our property arising out of, or occasioned by, directly or indirectly, my child's participation in this activity, and (b) that it is my/our intent to release GAD, it members, ministers, board, agents, and employees from liability even if the personal injuries or property damage is caused by the sole negligence of GAD, its members, ministers, board, agents or employees.

Participation includes possible exposure to, and illness from, any infectious diseases typical in community events. While particular rules and personal discipline may reduce this risk, the risk of serious illness and/or possible death does exist; I knowingly and freely assume all such risks related to illness and infectious diseases to the participant, even if arising from the negligence or fault of Dynamos and its pariticpating leaders; and I hereby knowingly assume the risk of injury, harm and loss associated with the activity for the participant, including any injury, harm and loss caused by the negligence, fault or conduct of any kind on the part of Dynamos and its participating leaders.

I hereby release and discharge the Gulf Atlantic Diocese and all affiliated entities from any and all claims, demands, or causes of action that I have in connection with the use and exercise of the rights granted in this release.

THIS REQUIRES THE PARENT'S SIGNATURE. A student signature is not acceptable.