Z experience REGISTRATION FORM

Name

First Name

Last Name

Email Address

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Emergency Contact Information

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Emergency Contact E-mail

(must be different than your personal e-mail address listed above)

Relationship to Emergency Contact

Payment Type

Name of Sponsor

Registration Information

Choose a weekend

How did you hear about us?

Weekend experience will not be confirmed until payment of $125 has been received

Agree

Terms of Service ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH THIS EVENT, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. I certify that I am physically fit to perform the activities that I choose to be involved in, understand that I do not have to engage in any activity that I am not comfortable engaging in and understand that I may notify any released party that I am not going to participate in any activity. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, volunteers, and organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity. In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: The Altamesa Church of Christ, Illuminate Ministries, and/or its employees, volunteers, representatives, The Watchtower Ranch, its owners (Fort Worth Silverstone Ltd. ) or agents, and the activity facilitators, servers, and volunteers; (B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise. I acknowledge that any activity in which I am requested to participate in that I am free to choose not to participate in and by participating I acknowledge that I am physically fit to participate in the activity. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity. I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns. The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. Participant further acknowledges, consents, and accepts that Watchtower Ranch is an alcohol, tobacco, and drug free facility. Participants may bring any prescription medications for which they have a valid legal prescription or other over the counter medication. Participants further acknowledges, consents, and accepts that Watchtower Ranch is a burn free facility and that participants may not light any fires on the ranch premises at any time.

LIABILITY WAIVER

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT.

Agree

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