Daystar Church - Leduc, CA - Whiteout Waiver Form

WHITEOUT 2025 WAIVER FORM

Student Information

Please fill out for every student coming to Whiteout 2025. If you are over 18, please fill this form out for yourself.

Student First Name

Student Last Name

Alberta Health Number

Parent/Legal Guardian Information

RELEASE OF LIABILITY, WAIVER OF ALL POSSIBLE CLAIMS, AND ASSUMPTION OF RISK

I give permission for child/children (identified as "Student" above) to attend and participate in the Whiteout 2025 retreat at Camp Nakamun, February 28-March 2, 2025 and any activities that the retreat might include. I authorize any of the retreat staff and/or youth leaders to act on my behalf in any emergency situation including those requiring medical attention. I understand that an event of this nature includes a certain amount of risk. I waive my legal rights to sue any staff, leaders, volunteers, facilities, transportation, Daystar Church, or any other participating churches for anything that might happen to myself, my child, and/or personal belongings while traveling and taking part in the Whiteout 2025 retreat.

Please Select Yes or No

Yes

PHOTOGRAPHY CONSENT

I give permission to take and use my photograph and/or my child's/children's photograph for inclusion in public information and promotional materials produced by Daystar Church

Yes or No

Yes

NON-EMERGENCY MEDICATION CONSENT

I give permission for the camp nurse to give my child/children non-emergency medication such as Advil, Tylenol, Gravol, or Benadryl if needed

Select

Yes

By signing this you are waiving your legal rights and you give up the right to sue.

Parent/Legal Guardian First and Last Name

Parent/Legal Guardian Signature

Date Input

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