Release and Acknowledgment of Risks
In consideration of the services of Journeymen Triangle, including all of their officers, directors, staff, leaders, co-leaders, volunteers, affiliates and all persons and entities acting for them or on their behalf (hereinafter collectively referred to as “Journeymen”) and the right to engage in this weekend (“Weekend”) as a participant I hereby freely and voluntarily agree to release, indemnify, and hold Journeymen harmless on behalf of myself, my children, my parents, my heirs, assigns, personal representatives and estate, as follows:
I. DISCLOSURE AND ACKNOWLEDGMENT OF RISKS
I understand that the Weekend is a personal growth and development course and involves known and unanticipated risks which could result in physical or emotional injury, paralysis, death, illness, or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. These risks include, but are not limited to:
- The nature of Weekend itself, which involves:
- Strenuous and vigorous, physical, mental, emotional, and intellectual activity such as outdoor and indoor games during day or night, role playing (e.g. enactments of past events, feelings or parts of psyche or personality) and exercises and processes which may include or result in physical, mental or emotional stress, distress and fatigue (e.g. facing and overcoming physical, emotional or mental obstacles to the achievement of goals);
- The potential for death; for injury to skeletal-neuromuscular system (such as strains, fractures, ruptures, bruises, loss of limb or loss of use of limb, paraplegia and quadriplegia), to internal organs, to cardiovascular system (such as elevated blood pressure, elevated pulse, heart attack, aneurysm, hemorrhage or stroke), to eyes or ears (loss of sight or hearing), to body (such as scrapes, scratches, punctures, lacerations) and to mental health (such as depression or re-traumatization relating to past psychological history).
- The potential for change with respect to such matters as: education, career, job or business; relationships with family, friends, women, youth, co-workers, and behavior in social, personal or school and business settings.
- The acts or omissions of Journeymen who may, among other things, be ignorant of any participant’s fitness or abilities; misjudge the weather, the elements, or the terrain; or give inadequate instructions, warnings or advice.
- Latent or apparent defects or conditions in the equipment or property supplied by Journeymen or other persons or entities as well as the use or operation of such equipment.
- Acts of other participants in this training or other persons.
II. STAFFER UNDERTAKINGS
- I and my representatives expressly acknowledge and agree and promise to accept all of the risks existing in this training, including those risks listed above as well as those risks not specifically listed above.
- I and my representatives understand, acknowledge and represent that my participation in this Weekend and in every separate part thereof is purely voluntary and I elect to participate in spite of and with full knowledge of all the risks. I acknowledge that at all times I will be free to choose to leave the training or to not engage in any part or all of the Weekend.
- I and my representatives hereby authorize Journeymen to take any and all reasonable steps on behalf of me or my Participant in the case of any physical or other injury, illness or condition me or my Participant might suffer during Weekend. In the event of a medical emergency or potential medical emergency, Journeymen will refer me to the appropriate level of care and/or treatment center. Journeymen is hereby authorized to apply emergency first aid, engage physicians of any kind, nursing services, ambulance services, paramedic services, or any other service or personnel that in the sole discretion and judgment if Journeymen may be deemed reasonable and necessary for my immediate care, health and safety.
- I and my representatives hereby voluntarily release, forever discharge Journeymen and agree to indemnify and hold Journeymen harmless with respect to any and all liability, claims, demands, or causes of action and damages which arise out of, or are in any way connected with, my participation in this Weekend, my use of Journeymen equipment or facilities, or the provision by Journeymen of emergency services, including but not limited to claims alleging negligent acts or omissions or medical malpractice.
- I and my representatives additionally release and forever discharge Journeymen Triangle, A Chapter of Boys to Men International and agree to indemnify and hold them harmless with respect to any and all liability, claims, demands, or causes of action and damages which arise out of, or are in any way connected with, my participation in this Weekend, my use of campsite equipment or facilities.
- I agree and promise to indemnify and hold Journeymen harmless from all costs and liabilities, including but not limited to, attorney fees, incurred by Journeymen in connection with claims for personal injury or property damage to staff, other participants, volunteers, spectators or other third parties which arise out of, or are in any way connected with, my participation in this Weekend.
- In agreeing to these terms & conditions, I fully recognize and acknowledge that if anyone (including myself) is hurt or property is damaged, lost, or destroyed, as a result of my participation in this Weekend, I may be found by a court of law to have given up any right I might have to make a claim or file a lawsuit against Journeymen.
- Should Journeymen or anyone acting on their behalf be required to incur attorney fees and costs in connection with any effort to enforce this agreement as a result of my participation in this Weekend, I agree and promise to indemnify and hold them harmless against all such fees and costs.
- I certify that I have sufficient health, accident and liability insurance to cover costs and expenses of any injury or damage I may suffer or cause while participating in this Weekend. If I have no such insurance I agree to bear all the costs of any and all such expenses and liability.
- I certify that I have completed the confidential medical questionnaire form required by Journeymen; that I have disclosed each and every physical, emotional or mental condition for which I have received treatment or am currently receiving treatment; that the information I have provided pertaining to my physical, emotional or mental condition is complete and true; and that I have complied with the medical requirements of Journeymen. I further certify that I have no medical condition which could interfere with my safety in the training and agree to assume and bear the costs of all risks, liability, claims, demands, or causes of action and damages which arise out of, or are in any way connected with any medical condition I have whether or not I have previously disclosed that condition to Journeymen.
- I have sufficient opportunity to read and understand this entire document. I have read and understood it. I agree to be bound by all of its terms.
III. CONFIDENTIALITY AND MANDATED REPORTING
- I understand that during Weekend, participants will have the opportunity to share deeply about who they are, their lives, and both positive and negative experiences which may include very personal information or content related to traumatic events. I further understand that what is shared by the participants is to be kept confidential, except in the following circumstances that fall under mandated reporting:
- I understand that as a Journeymen Weekend participant, I fall under the category of mandated reporter, and that I am required by law to report to the proper authorities anything a participant shares with that shows that he is or may be endangering his physical safety or the physical safety of someone else.
- I understand also that as a mandated reporter I must report any suspected child abuse or neglect immediately. All such reports must be made to the appropriate state and/or county authorities. Program staff must follow the mandatory reporting of child abuse and neglect procedure.