FUEL Summer Camping Waiver 2026

For students who attend High School, you are invited to FUEL High School Retreat - The following fields must be completed to attend (liability purposes).

Your name *

Email address *

CONSENT FOR ALL PARENTS OR LEGAL GUARDIANS OF CHILDREN (LESS THAN 18 YEARS OLD) WHO ARE PARTICIPATING IN ANY ACTIVITY WITH LIFE WEST CHURCH

I consent to allow any of my children listed below to participate in an activity, event or program sponsored by Life West Church (LWC).
In the event of an emergency where medical treatment is necessary, I authorize LWC to obtain the services of a licensed physician and/or certified paramedic for me and/or any of my children listed below. I agree that any such expense will be my own obligation. I have provided phone numbers below that may be used in the event of an emergency. I agree to update these contact numbers if there is a change.

Parent or Legal Guardian Signature *

Print Name of Child *

DOB *

Emergency Contact *

Phone Number *

LIABILITY RELEASE TO BE SIGNED BY INDIVIDUAL OVER THE AGE OF 18 or PARENT/LEGAL GUARDIAN

I, (PLEASE PRINT)_________________________________________ individually, or in my capacity as a parent or legal guardian of the above listed child(ren), hereby provide a full and complete release of any liability and indemnification, past or future, which may be claimed against LWC, and its agents, trustees, officers, employees, members, attendees, representatives, any volunteers and specifically includes all claims and demands of whatever nature, actions, damages, costs, loss of services, expenses and compensation on account of or in any way growing out of personal injuries, illnesses, and/or property damage having already resulted or to result at any time in the future, whether or not contemplated at the present time or whether or not they arise following the execution of this release. For the consideration stated above, I further agree that in the event that my child or I should make any claim against LWC for damages arising out of the above named activity, we will personally indemnify, defend, and hold harmless, and its agents, trustees, officers, employees, members, attendees, representatives, and any volunteers against any and all loss and damage occasioned thereby, including attorney's fees.
I understand that LWC may take photographs of me, my child(ten) and my family in the course of its activities, and I grant LWC permission to publish such photographs in a manner LWC deem appropriate.
This Liability Release Form is in effect for ALL events or activities that I, or any of my children, may participate in. This release form is revocable, prospectively only, by a writing signed by me that bears the date that the revocation is delivered to LWC.

Date *

Individual over 18 or Parent/Legal Guardian *

sign for above statement