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In order for campers to attend this camp and participate in any activities, you must agree to the following terms and conditions.


I, the parent or guardian of the above named participant, give my voluntary consent to his/her participation in Kedleston Gospel Camp activities and agree to all conditions of enrollment in this camp. I authorize Kedleston Gospel Camp to approve and obtain any and all medical attention and medical staff in the case of a medical emergency; with the understanding that all reasonable attempts have been made to consult with myself beforehand except in case of minor illness and/or first aid where deemed appropriate; with the understanding that I will take responsibility for any additional expenses that may result from such services.



I am aware that Kedleston Gospel Camp offers activities such as climbing on Jacob’s Ladder (a four sided climbing wall and aerial park), mountain biking, canoeing, kayaking, tubing, knee boarding, water-skiing, wakeboarding, surfing behind motorized boats, swimming, jumping and climbing on a floating water trampoline and playground, archery, fishing, and jumping on a trampoline which all have a potential for injury. I understand that such activities involve certain risks, including but not limited to, drowning, collisions, and falling to the ground. I understand that the participation of the above named in such activities exposes them to risk and may result in injuries, including but not limited to, death, serious neck and spinal injuries resulting in complete or partial paralysis, brain damage and serious injury to virtually all bones, joints, muscles and internal organs. I further understand that a number of these activities involve a particularly high risk of tendon and joint injury, especially in the fingers, wrists, elbow, and shoulder.


I am voluntarily allowing the participation of the above named in the activities offered at Kedleston Gospel Camp with the knowledge of the danger involved and that accidents and equipment failure can happen. I hereby agree to accept any and all inherent risks of personal injury,   death or property injury.



I release Kedleston Gospel Camp, its trustees, directors, corporation members, staff, and agents from any loss, personal injury, accident, misfortune or damage to the above named or his/her property, with the understanding that reasonable precautions shall be taken to ensure the health and safety of the above named. I understand that Kedleston Gospel Camp, its staff or agents reserve the right to dismiss a participant who is in their opinion a hazard to the safety and well-being of others, who appears to have rejected the reasonable guidelines of the activity.


I understand that if there are any activities that I do not want the above named to participate in, it is therefore my, the parent/guardian’s, responsibility to inform the Camp. Failure to disclose problems at time of application could result in dismissal.


I have read all the information in this waiver and accept the conditions of enrollment with the full knowledge that this form with my signature may be used as a legal document in any court of law.


To show that you agree to these terms and conditions and have the proper authority to do so, please provide the following information about yourself.


Your Name



Your Birth Date



Security Question





[ ]  * I have read and agree to the above terms

[ ]  * I have the authority to act as a legal guardian in signing this waiver

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