Nature Bible Camp 2026-Teen Staff waiver

Thank you for helping out with this year’s Nature Bible Camp from June 16-18, 2026 at Branbury State Park from 10 am to 3 pm. Because you are under 18 years old, we need a release form signed by your parent/guardian.

Please sign and complete this form by May 7, 2026.
More information on supplies and expectations will be given by email prior to our start.

Parent/Guardian Name

Parent/Guardian Email

This address will receive a confirmation email

Emergency Phone #

Name of teen and grade entering

This address will receive a confirmation email

Phone

Please provide any special dietary restrictions or allergies that we should know of

Waivers

PLEASE REVIEW THIS “GENERAL RELEASE AND COVENANT NOT TO SUE” AND CONFIRM YOUR UNDERSTANDING OF ITS CONTENTS. YOUR AGREEMENT TO BE BOUND BY ITS TERMS IS A CONDITION OF YOUR PARTICIPATION IN THE RETREAT AND ACTIVITIES.

I certify and affirm that I have been fully informed that by participating in the 2026 Nature Bible Camp, my child(ren) will participate in certain activities that involve inherent risks and potential dangers. I understand that this Authorization, Consent, and Release remains in effect regardless of whether the activities are provided free of charge or for a fee. I voluntarily assume all risks associated with participation for my child(ren), including any harm, injury, or damages that may occur, whether known or unknown, foreseen or unforeseen. I still choose for them to participate. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless the staff and volunteers of Middlebury Congregational Church, St. Stephen’s Church and St. Mary’s Church from any and all claims, demands, or causes of action connected to my child(ren)’s participation in camp activities. I understand that I am responsible for informing the staff of any health considerations or medical conditions that may limit my child(ren)’s ability to safely participate in any activities. In the event of an emergency, I authorize the examination and/or treatment by a licensed physician or other licensed health care provider in the United States, as deemed necessary. I give permission for any medical professional to provide any and all treatment considered appropriate in their professional judgment. I agree to be financially responsible for all medical expenses incurred as a result of this authorization. I acknowledge that by signing this document, I may be waiving the right to bring legal action against the churches if my child(ren) is injured or property is damaged during participation. I agree that if any part of this agreement is found to be invalid or unenforceable, the remainder shall continue in full force and effect. I confirm that I have read and understood the contents of this Authorization, Consent, and Release prior to signing. Signature and date

MEDIA RELEASE FORM

Please read the following statement carefully: I irrevocably consent to and authorize the Congregational Church of Middlebury, UCC, St. Stephen’s Church and St. Mary’s Church to use, reproduce, and publish—in any medium—all forms of media content captured during camp activities, including photographs, video recordings, and audio recordings, as specified below. I further authorize the above named churches to use my name or, if I choose, a fictitious name, in connection with the above media. I acknowledge that the three churches retains the right to edit, copyright, and distribute these materials for lawful promotional, educational, or informational purposes, without compensation to me. I understand and expect that the churches will make reasonable efforts to contact me should the use of my image, voice, or performance be proposed for purposes beyond those outlined below. Types of Media Use: Church website (e.g., event highlights, galleries, blog posts) Church’s social media (e.g., Facebook, Instagram, YouTube) Printed promotional materials (e.g., flyers, brochures, newsletters) Church bulletins or presentations.

Media Release

I consent to any media use by the Church I do not consent to any media use (no photos, videos, or recordings).

Description

Tuesday, June 16 - Thursday June 18, 2026

Please fill out this form and click submit. The payment at the end is a suggested donation but you can opt out by selecting "0". If you wish to contribute by cash or check, they can be made to Middlebury Congregational Church and brought on the first day of camp. Thank you so much for your generosity.

For more information, contact may@midducc.org.

Nature Bible Camp 2026-Teen Staff waiver

Description

Please Fix the Following