Acceptance of Risk & Waiver/Release of Liabilities: I attest and covenant that I and any others registered on this form including any children and adults in my party (“my party”) are healthy and free of any physical or psychological problems that could be detrimental to my or my party’s health or happiness or that of other campers. I understand that Camp’s directors, at their sole discretion, reserve the right to dismiss a participant for undesirable behavior, safety concerns, health-related concerns, or for other cause determined by Camp. I confirm I have read and understand Camp’s policies document provided with this application. I confirm I will read any updates, policies, and information provided after this application, including but not limited to health and food allergy information.  

I agree to participate in all activities offered by Camp. I acknowledge that even after reasonable precautions have been taken, Camp and its activities have inherent risks, (collectively, “risks”), including but not limited to the risks of being in and on the water, playing sports, living mostly outdoors in the woods with the dangers of severe weather, wood fall, insects and animals, communicable diseases, etc. I further acknowledge that such inherent risks cannot be eliminated without destroying the unique character of Camp and its activities, and I hereby assume all such risks and hazards incident to my participation in all of Camp and its activities. I grant permission to Camp to transport me or others registered in my party in Camp vehicles as needed during our stay. I hereby release, absolve, indemnify, and do not hold responsible Belknap, its participants, administrators, board of trustees, directors, volunteers, or any staff appointed by Camp, for any risk, legal claim, hazards, damages, costs for any physical injury, or accidents to me, or damage sustained to my personal property, that may occur during my time at Belknap or while participating in Camp activities.  

I understand that cyanobacteria (blue-green algae) are naturally occurring microorganisms that can multiply rapidly under certain environmental conditions, forming harmful algal blooms (HABs). These blooms may produce toxins (“cyanotoxins”) that can cause skin irritation, eye or ear irritation, gastrointestinal illness, respiratory irritation, or in rare cases, liver or neurological effects in humans or animals exposed through contact, ingestion, or inhalation. I understand that the presence or toxicity of cyanobacteria cannot always be detected by sight, smell, or water clarity: blooms may appear or change rapidly and unpredictably. Belknap monitors water conditions and coordinates with New Hampshire Department of Environmental Services (NHDES), but cannot guarantee that any particular swimming area is free from cyanobacteria or toxins at all times. Participants will be notified promptly if a bloom or advisory occurs, and swimming activities may be restricted or suspended accordingly. 

Health & Infectious Diseases: I grant permission to Belknap to administer screening, testing, health checks and medical care in the event of injury or illness or for the prevention of illness. I understand that there are no health services on camp during this camp program and that I am responsible for my health. In the event of a serious illness/injury, I grant Belknap permission to send me to a clinic/hospital and permit medical aid to be administered as deemed medically necessary. I authorize Camp’s directors to act for me in their best judgment in any emergency. 

I understand that while Camp is taking all reasonable precautions to prevent the spread of Covid and other communicable diseases as recommended by the U.S. Centers for Disease Control and Prevention and other governmental authorities, there is a still a risk that, by entering Camp’s premises and interacting with Camp’s employees, representatives, agents, or other participants, I and those in my party are at risk for contracting Covid and other communicable diseases, which can lead to severe illness, personal injury, permanent disability, and death. Participating in Camp or accessing Camp’s facilities could increase the risk of contracting Covid and other communicable diseases. Camp in no way warrants, represents, or covenants that a communicable infection will not occur through participation in Camp or accessing Camp’s facilities. My party (if applicable) and I agree to adhere to and obey all written rules, instructions, warnings, industry standards, safety requirements including vaccination mandates or procedures and further agree to follow any oral instructions given by Camp or its employees, representatives, and/or agents and other related authorities. My party (if applicable) and I take full responsibility for ourselves and children (if applicable) for knowing and acting within our abilities and limitations and adjusting or ceasing participation as needed to ensure our safety and the safety of others.  

Risks Defined: As used herein, “risks” means any and all risks resulting from, or related to my or my party’s access to Camp’s premises, my or my party’s interaction with Camp’s employees, representatives, and agents, or other campers, as well as engaging in Camp activities and programs, including, without limitation: (a) those arising from or related to, in whole or part, any negligence, action(s), inaction(s), or omission(s) of Camp, including but not limited to those arising from or related to the maintenance of any premises; (b) those arising from or related to, in whole or part, my or my party’s negligence, action(s), inaction(s), omission(s), or intentional or wrongful acts; (c) those arising from or related to, in whole or part, my or my party’s harm, bodily injury, personal injury, illness, death, property damage and/or property theft; (d) those arising from or related to actions of any kind caused by my or my party’s negligence, action(s), inaction(s), or intentional or wrongful acts, or which may hereafter occur through no fault, wrongdoing, or negligence of Camp; and (e) those arising from or related to any illness, injuries, loss, expense, or damage of any kind to any person or property arising in whole or in part, directly or indirectly, from my or my party’s own negligence, action(s), inaction(s), omission(s), intentional acts, or wrongful acts. 

Use of Likeness, etc.: I grant permission to Belknap to use for any lawful purpose my and my party’s likeness, image, voice, written materials, spoken words, artworks, and/or appearance as such may be embodied in any pictures, drawings, renderings, photographs, video recordings, audiotapes, digital images, or the like (“materials”). I hereby authorize Belknap to copy, edit, publish, display, distribute, and/or disseminate the materials. I agree that Belknap has complete ownership of and may use the materials in any manner for any purpose in any medium, including, but not limited to, social media sites. I also agree that Belknap has permission to release such materials to the news media. I acknowledge that I will not receive any compensation or remuneration for the use of such materials. 

I HAVE READ AND UNDERSTOOD THIS WAIVER AND RELEASE OF LIABILITY. I CERTIFY THAT I AND THOSE IN MY PARTY ARE PHYSICALLY AND MENTALLY FIT TO TAKE PART IN ALL CAMPER ACTIVITIES AND I UNDERSTAND THE NATURE OF THE RISKS THAT MAY ARISE FROM CAMP AND CAMP ACTIVITIES AND VOLUNTARILY ASSUME ALL SUCH RISKS. I ACKNOWLEDGE THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE BELKNAP. I acknowledge and agree that all representations, consents, agreements, grants, waivers, authorizations, indemnifications, and releases herein shall be regarded as made by me on behalf of my party (if applicable) and shall be binding on me and my party. Furthermore, in consideration of releases possibly including me and/or my party in Camp, I hereby agree to be bound by and to perform all of the terms and conditions of the foregoing release (including, without limitation, the provisions regarding release of all claims), as such terms and conditions may relate to my participation and/or the participation of my party in Camp and its programs. 
 

My electronic signature confirms understanding, acknowledgement, and acceptance of these rules and expectations.