R9, 2025-01-11

NOTE: Elijah's Retreat does not accept paper waivers, please submit electronically.

Waiver and Release of Liability for Elijah's Retreat

THIS FORM MUST BE COMPLETED BY ANYONE OVER THE AGE OF 18 PRIOR TO OR IMMEDIATELY UPON ARRIVAL AT ELIJAH’S RETREAT.
READ CAREFULLY - THIS AFFECTS YOUR LEGAL RIGHTS

I wish for my family/dependent and I to visit or volunteer and/or participate in activities sponsored by the nonprofit known as Elijah’s Retreat. I understand that my family/dependent and I do so at our own risk. In exchange for being permitted to visit or volunteer and/or participate in activities, I hereby release and waive Elijah’s Retreat, any volunteers, employees, officers, board members, affiliated group, the property owner and the Torres Family in particular from liability for any and all loss, damage, injury, claims, demands, lawsuits, expenses and any other liability, even damage or injury arising from negligence or willful disregard, of or to me or any other person or my family, directly or indirectly arising out of or in connection with my visit, volunteering and or participation in any activity.

I understand that there are inherent risks involved with the activities that are performed at Elijah’s retreat. I understand that the animals on the property may kick or bite at any time. I understand that there is heavy equipment and tools in use and stored on the property. I understand that there is wildlife and unmanaged
vegetation on the property. I understand that horseback riding is inherently dangerous and can cause damage, injury or death. I understand that there are inherent risks involved in activities on the Jumping pillow that may cause
damage, injury or death. I understand that interaction or proximity to the hazards mentioned and not mentioned on the property can cause damage, injury or death.
I further hold harmless, indemnify, and reimburse the released parties from and for any sums, costs or expenses incurred by any of the released parties or paid by them to any person (including me or my insurers) in connection with any accident, loss, damage, or injury sustained by me or others in connection with my attendance, volunteering at or participation in the above-described activity. This means that I will reimburse the released parties if anyone makes a claim against them based on the damages or injuries I and/ or my family/ dependent may suffer.

I agree to pay for all damages to the facilities of Elijah's Retreat caused by any negligent, reckless, or willful actions by me or my family. Any legal or equitable claim that may arise from participation in the above shall be resolved under Texas law. I confirm that I am over 18 years of age.

I agree and acknowledge that I am under no pressure or duress to sign this Agreement and that I have been given a reasonable opportunity to review it before signing. I further agree and acknowledge that I am free to have my own legal counsel review this Agreement if I so desire. I further agree and acknowledge that Elijah's Retreat has offered to refund any fees I have paid to use its facilities if I choose not to sign this Agreement.

Photo Release

For good and valuable consideration, the receipt of which is hereby acknowledged, I, hereby grant Elijah's Retreat permission to use my likeness and the likeness of
my family in a photograph in any and all of its publications, including but not limited to all of Elijah's Retreat's printed and digital publications. I understand and agree that any photograph using my likeness will become property of Elijah's Retreat and will not be returned.

I acknowledge that since my participation with Elijah's Retreat is voluntary, I will receive no financial compensation.

I hereby irrevocably authorize Elijah's Retreat to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicizing Elijah's Retreat's programs or for any other related, lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein
my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph.

I hereby hold harmless and release and forever discharge Elijah's Retreat from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS.

Please select who will be participating:

First Minor's Information

               

Please write age of each participant

Are they on the Autism Spectrum? (For purposes of planning activities)

Second Minor's Information

               

Please write age of each participant

Are they on the Autism Spectrum? (For purposes of planning activities)

Third Minor's Information

               

Please write age of each participant

Are they on the Autism Spectrum? (For purposes of planning activities)

Fourth Minor's Information

               

Please write age of each participant

Are they on the Autism Spectrum? (For purposes of planning activities)

Fifth Minor's Information

               

Please write age of each participant

Are they on the Autism Spectrum? (For purposes of planning activities)

Sixth Minor's Information

               

Please write age of each participant

Are they on the Autism Spectrum? (For purposes of planning activities)




Please list any special requests.


Click to Sign
Signature

By checking here, you acknowledge you have read and understand the above terms, and are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.