CAMP COTUBIC, INC.
Release (for campers under the ages of 18)
In consideration of __________________________________ being permitted to participate in the
(name of camper)
United Youth Camp (United Church of God) being held at Camp Cotubic in Bellefontaine, Ohio, beginning on June 15, 2014 and ending on June 22, 2014, I, the undersigned, being the parent or guardian (“Releasor”) hereby release, waive, discharge, covenant not to sue, agree to indemnify and hold harmless, Camp Cotubic and their officers, directors, agents, affiliates, employees, and assigns (“Releases”) from any and all negligence of Releases or otherwise, arising out of or relating his/her presence or participation in the aforementioned United Youth Camp at Camp Cotubic and any activities related thereto.
This release shall be binding on myself, the above named camper, my heirs, executors and legal representatives.
____________________________________
Name of parent or guardian (please print)
____________________________________
Signature of parent or guardian
____________________________________
Date