Dear Parents and Guardians

We at Pine Cove, Inc. (“Pine Cove”) want to inform you of our safety precautions at camp. We feel that we have hired competent and knowledgeable staff. Nonetheless, your camper will be required by our staff to wear safety equipment for water sports, horsemanship, ropes challenge courses and other activities requiring protective gear.

Even with safety equipment, we at Pine Cove want you to realize that any outdoor camping and recreational activity has inherent dangers that no amount of care, caution, instruction or expertise can eliminate.

IT IS MANDATORY THAT THIS FORM IS FILLED OUT, SIGNED, AND DATED BY THE PARENT(S) OR GUARDIAN(S) OF THE CAMPER AND RETURNED. YOUR CAMPER WILL NOT BE PERMITTED TO ATTENDCAMP UNLESS WE HAVE RECEIVED THIS FORM.

• I hereby affirm that I have been advised of and understand the risks of camping and recreational activities at Pine Cove and that such activities involve dangers and risks and I accept those dangers and risks knowingly.

• I understand that pictures and videos are taken at camp. I hereby give permission for the use of such pictures and videos of my camper for the promotion of Pine Cove.

• In addition, I give permission for my camper to be transported in vehicles for camp approved transportation and activities at Pine Cove and other locations.

• I understand that the terms herein are contractual and not a mere recital.

• In signing this document, I hereby certify that I give permission to my camper to participate in the camping program of Pine Cove.

• I have signed this document as my own free act and in consideration of the agreement by Pine Cove to accept my camper for the camp program circled below.

• BY EXECUTION OF THIS DOCUMENT, I KNOWINGLY AND WILLINGLY RELEASE PINE COVE, THE STAFF, THE BOARD OF DIRECTORS, AND ALL OTHERS ACTING FOR OR ON BEHALF OF PINE COVE FROM ALL LIABILITY WHATSOEVER, FOR PERSONAL INJURY, OR INJURIES TO PROPERTY, REAL OR PERSONAL, CAUSED BY, OR ARISING OUT OF CAMPING AND OTHER ACTIVITIES SPONSORED BY PINE COVE.