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COMBINED CONSENT, PERMISSION AND RELEASES FOR PARTICIPATION IN CATHOLIC CHARITIES DIOCESE OF CLEVELAND CAMP CHRISTOPHER SUMMER CAMP PROGRAMMING

1. PERMISSION FOR MEDICAL TREATMENT AND RELEASE OF LIABILITY

I hereby give permission and authorize Catholic Charities Corporation, dba Catholic Charities Diocese of Cleveland and/or Camp Christopher(hereinafter “CCDC”), and their employees or agents to provide medical care including but not limited to the administration of prescribed medications and the delivery of first aid care to me or to the program member for whom I am parent or legal guardian (hereinafter “Program Member”). I hereby give permission and authorize CCDC, and their employees and agents to act on my behalf, or on the behalf of the Program Member, to seek medical treatment in the case of illness or accident from a medical practitioner or hospital and to arrange necessary related medical transportation. Should medical attention be required to care for me or for the Program Member, I agree to pay any expenses incurred.

In consideration of my participation or the participation of the Program Member in a CCDC program, and wishing to promote and benefit this non-profit cause, on behalf of myself and the Program Member, I hereby release, indemnify, hold harmless and defend Catholic Charities Corporation, dba Catholic Charities Diocese of Cleveland, Camp Christopher, the Diocese of Cleveland Facilities Services Corporation, the Catholic Diocese of Cleveland and the Bishop or Administrator of the Diocese of Cleveland, and any of their members, directors, officers, agents, employees, servants, representatives, attorneys, licensees, successors and assigns, from any and all liability for claims and demands arising out my medical care or the medical care of me and/or the Program Member. I, on behalf of myself and the Program Member, specifically waive any rights and claims that I and/or the Program Member may have as well as any other claims for damages in law or equity.

2. PERMISSION TO PARTICIPATE IN FIELD TRIPS AND RELEASE OF LIABILITY

I hereby give permission and authorize Catholic Charities Corporation, dba Catholic Charities Diocese of Cleveland and/or Camp Christopher (hereinafter CCDC), and their employees and agents to include me or the Program Member for whom I am parent or legal guardian in any and all travel and/or field trips offered by CCDC throughout the term of the program. I am aware that travel of any kind, whether by vehicle, foot, or any other means, constitutes a field trip. I understand that it is my responsibility to ascertain my physical fitness or the physical fitness of the program member to participate in any and all field trips of the program.

In consideration of my participation or the participation of the Program Member in a CCDC program, and wishing to promote and benefit this non-profit cause, on behalf of myself and the Program Member , I hereby indemnify, hold harmless and defend Catholic Charities Corporation, dba Catholic Charities Diocese of Cleveland, Camp Christopher, the Diocese of Cleveland Facilities Services Corporation, the Catholic Diocese of Cleveland and the Bishop or Administrator of the Diocese of Cleveland, and any of their members, directors, officers, agents, employees, servants, representatives, attorneys, licensees, successors and assigns, from any and all liability for claims and demands arising out of my participation or the participation of the Program Member in any field trips. I specifically waive any rights and claims for damages in law or equity on behalf of myself and the Program Member.

3. Permission to Participate in Activities AND/OR USE Swimming Pool and lakes and Release OF LIABILITY

I hereby give consent for me or for the Program Member for whom I am parent or legal guardian (hereinafter “the program member”) to participate in activities at, near or in the lakes at Camp Christopher while participating in CCDC programs at Camp Christopher.

As a parent or guardian of the Program Member, I recognize and acknowledge that there are certain risks of injury involved in activities at, near or in a body of water, and the Program Member and I agree to assume the full risk of any and all injuries, including loss of life, damages or other losses that I or the Program Member might sustain as a result of my or the Program Member’s participation in activities at, near or in the lakes at Camp Christopher, while participating in CCDC programming at Camp Christopher.

In consideration of my being permitted or of the Program Member being permitted to participate in activities at, near or in the lakes of Camp Christopher, while I or the Program Member participate in CCDC programming at Camp Christopher, I agree on my behalf and on the behalf of the program member, to waive and relinquish all claims and to fully release and discharge and agree to the extent permitted by law, to indemnify, hold harmless and defend Catholic Charities Corporation, dba Catholic Charities Diocese of Cleveland, Camp Christopher, the Diocese of Cleveland Facilities Services Corporation, the Catholic Diocese of Cleveland and the Bishop or Administrator of the Diocese of Cleveland, and any of their members, directors, officers, agents, employees, servants, representatives, attorneys, licensees, successors and assigns from any and all claims resulting from injuries, including loss of life, damages or other losses including but not limited to the administration of emergency medical treatment, for injuries sustained by me and/or the Program Member arising out of, connected with or in any way associated with participation in the activities at, near or in the lakes at Camp Christopher while I or the Program Member participate in CCDC programming at Camp Christopher.

4. Permission to Participate in Equine Activities and Release OF LIABILITY

I hereby give consent for me or the Program Member for whom I am parent or legal guardian to participate in equine activities, including those associated with the Catholic Charities Corporation, dba Catholic Charities Diocese of Cleveland and/or Camp Christopher, (hereinafter CCDC) Horseback Riding Program, and knowingly and willingly assume on behalf of myself and the Program Member all inherent risks of equine activities and harm resulting therefrom, including the injury or death of the Program Member, whether caused by the negligence of CCDC or any other cause.

I understand, acknowledge, and agree on behalf of myself and the Program Member that there is always an inherent risk of harm, including injury, death, or loss to person or property, associated with equine activities, whether working around, riding, and/or merely being a spectator observing equines, and that Ohio law grants CCDC immunity from liability in damages in a tort or other civil action for any harm sustained by me or by the Program Member during an equine activity and resulting from an “inherent risk of an equine activity” under certain circumstances. See O.R.C. 2305.321. I further understand and acknowledge on behalf of myself and the Program Member that “inherent risk of an equine activity” refers to a danger or condition that is an integral part of an equine activity, including, but not limited to:

(a) The propensity of an equine to behave in ways that may result in injury, death, or loss to persons on or around the equine;

(b) The unpredictability of an equine’s reaction to sounds, sudden movement, unfamiliar objects, persons, or other animals;

(c) Hazards, including, but not limited to, surface or subsurface conditions;

(d) A collision with another equine, another animal, a person, or an object;

(e) The potential of an equine activity participant to act in a negligent manner that may contribute to injury,

death or loss to the person of the participant or to other persons, including, but not limited to, failing to maintain control over an equine or failing to act within the ability of the participant.

By way of example, and not by limitation, additional risks associated with equine activities include the failure or breaking of tack, being mounted on a horse or other equine which proves to be ill-matched to a rider’s ability, dangerous latent conditions on, near, or off the property, falling or being thrown from a horse or other equine, being kicked or bitten by a horse or other equine, being stepped on or run into by a horse or other equine, striking a protruding or overhanging object while mounted, or being dragged as a result of the rider’s foot slipping through a stirrup and becoming lodged therein.

I further understand and acknowledge on behalf of myself and the Program Member that I or the Program Member may be riding and controlling a horse by my/his/herself (i.e., not led on a lead rope) and may be riding in a riding ring, along a road, in a field, and/or in a forest on a trail ride, among other places. I also understand and acknowledge on behalf of myself and the Program Member that no warranties or representations of any kind have been made by CCDC regarding the disposition, temperament, training, or health of the horses or other equines used in the Horseback Riding Program.

In consideration for me and/or for the Program Member being permitting to enter Camp Christopher and to participate in equine activities, including, but not limited to, riding, exercising, handling, grooming, tacking, and otherwise working with or being around equines, on behalf of myself and the Program Member, I agree to waive and relinquish all claims and to fully release and discharge and agree to the extent permitted by law, to indemnify, hold harmless and defend Catholic Charities Corporation, dba Catholic Charities Diocese of Cleveland and/or Camp Christopher, Diocese of Cleveland Facilities Services Corporation, the Catholic Diocese of Cleveland and the Bishop or Administrator of the Catholic Diocese of Cleveland, and any of their members, directors, officers, agents, employees, servants, representatives, attorneys, licensees, successors and assigns from any and all claims resulting from injuries, including loss of life, damages or other losses including but not limited to the administration of emergency medical treatment, for injuries sustained by me and/or the Program Member arising out of, connected with or in any way associated with participation in equine activities at Camp Christopher.

5. PERMISSION TO PARTICIPATE IN ROPES COURSE, ZIP LINE AND ROCK CLIMBING ACTIVITIES AND RELEASE OF LIABILITY

I hereby give consent for me or the Program Member for whom I am parent or legal guardian to participate in both high and low ropes course activities, the zip line and rock climbing activities associated with the Catholic Charities Corporation, dba Catholic Charities Diocese of Cleveland and/or Camp Christopher (hereinafter CCDC) Camp Christopher Program, and knowingly and willingly assume all inherent risks of these activities and harm resulting therefrom on behalf of myself and the Program Member, including the injury or death of the Program, Member whether caused by the negligence of CCDC, or any other cause.

I understand, acknowledge, and agree on behalf of myself and the Program Member that there is always an inherent risk of harm, including injury, death, or loss to person or property, associated with ropes course, zip line and rock climbing activities. I further understand and acknowledge on behalf of myself and the Program Member that these are strenuous and psychologically demanding activities and require participants to be in good physical condition. Although it is impossible to foresee all possible dangers, I understand and acknowledge on behalf of myself and the Program Member that some specific risks the participant may encounter while using the ropes course, zip line and/or rock climbing activities might include, but are not limited to injury from slipping, falling, running, or jumping. I am aware and understand for myself and the Program Member that a potential risk of physical injury that may not only be from my/the Program Member’s own actions, inactions, or negligence, but also from the actions, inactions, or negligence of others, the condition of the environment, equipment, or areas where the event or activity is being conducted. I understand and acknowledge on behalf of myself and the Program Member that the programs are physically demanding and potentially dangerous. Therefore, I represent that I/the program member is free of medical or physical conditions, which might create undue risk to self or others who depend on me/the Program Member. I understand and acknowledge that I/the program member is responsible for behaving in a careful and prudent manner to minimize the risk of injury to self or others. I understand and acknowledge on behalf of myself and the Program Member that this is a voluntary program and that I/the Program Member should participate to the extent that I/the Program Member feel is appropriate to my/the Program Member’s physical condition and skill level. I understand and acknowledge on behalf of myself and the Program Member that I/the Program Member must not participate under the influence of drugs and alcohol, and agree not to participate in that Participant will not be able to participate if under the influence of drugs or alcohol.

In consideration for me and/or the Program Member being permitting to enter Camp Christopher and to participate in ropes course, zip line and/or rock climbing activities, on behalf of myself and the Program Member, I agree to waive and relinquish all claims and to fully release and discharge and agree to the extent permitted by law, to indemnify, hold harmless and defend Catholic Charities Corporation, dba Catholic Charities Diocese of Cleveland, Camp Christopher, the Diocese of Cleveland Facilities Services Corporation, the Catholic Diocese of Cleveland and the Bishop or Administrator of the Catholic Diocese of Cleveland, and any of their members, directors, officers, agents, employees, servants, representatives, attorneys, licensees, successors and assigns from any and all claims resulting from injuries, including loss of life, damages or other losses including but not limited to the administration of emergency medical treatment, for injuries sustained by myself and/or the Program Member arising out of, connected with or in any way associated with participation in ropes course, zip line and/or rock climbing activities at Camp Christopher.

6. PERMISSION TO RECORD AND USE IMAGES AND RELEASE OF LIABIITY

I hereby give permission and authorize Catholic Charities Corporation, dba Catholic Charities Diocese of Cleveland (hereinafter CCDC), Camp Christopher and the Catholic Community Foundation, and their employees and agents to photograph, or otherwise electronically or digitally record my image or the image of the Program Member for whom I am parent or legal guardian for publication in printed or electronic form, and for my image or that of the Program Member to be seen and disseminated to the general public in any media form, including, but not limited to CCDC newsletters, posters, displays, films, videos or websites, or social media.

In consideration of my participation or the participation of the Program Member in a CCDC program, and wishing to promote and benefit this non-profit cause, on behalf of myself and the program member, I hereby indemnify, hold harmless and defend Catholic Charities Corporation, dba Catholic Charities Diocese of Cleveland, Camp Christopher, the Diocese of Cleveland Facilities Services Corporation, the Catholic Diocese of Cleveland and the Bishop or Administrator of the Catholic Diocese of Cleveland, and the Catholic Community Foundation, and any of their members, directors, officers, agents, servants, representatives, attorneys, employees, licensees, successors and assigns, from any and all liability for claims and demands arising out of the use of my image or the image of the Program Member in any aforementioned media. I specifically waive any rights and claims that I may have or claim for privacy, invasion of privacy, libel, payment or royalties for use of the above-described photograph, as well as any other claims for damages in law or equity on behalf of myself and the Program Member.

7. ACCEPTANCE OF FINANCIAL RESPONSIBILITY AND RELEASE OF LIABILITY

I pledge on behalf of myself and the Program Member that all of the information contained in this application is accurate, complete and true. This application has my approval on behalf of myself and the Program Member, and I and/or the Program Member, agree to abide by the rules and decisions of Catholic Charities Corporation, dba Catholic Charities Diocese of Cleveland and/or Camp Christopher (hereinafter CCDC).I accept financial responsibility for any fees associated with my participation or the participation of the Program Member I am enrolling. I understand that all activities at Camp Christopher have certain risks and could result in injury or death. On behalf of myself and the Program Member, I specifically waive and relinquish all claims that I or the Program Member for whom I am parent or legal guardian might have, fully release and discharge and agree to indemnify, hold harmless and defend Catholic Charities Corporation, dba Catholic Charities Diocese of Cleveland, Camp Christopher, the Diocese of Cleveland Facilities Services Corporation, the Catholic Diocese of Cleveland and the Bishop or Administrator of the Catholic Diocese of Cleveland, and any of their members, directors, officers, agents, employees, servants, representatives, attorneys, licensees, successors and assigns, on behalf of myself and the Program Member, from any and all liability for claims and demands resulting from harms or injuries, including but not limited to loss of life, damages and losses sustained by me or by the program member arising out of, connected with or in any way associated with activities of CCDC.

 

Cancellation Policy: 

The deposit(s) paid at the time of registration is/are non-refundable. The balance of any fees paid is refundable for cancellations that occur 14 business days before the first day of the camper’s reserved session. Lost fees will not be credited toward later summers or transferred to other campers’ accounts. There will be no refunds for campers who must leave due to illness or who withdraw against the recommendation of the camp administration. No refunds will be given for campers who are required to leave due to violations of the camp rules or behavioral disruption. Examples of this type of behavior include verbal/physical threats or violence, damage to/destruction of property, and possessing or disbursing electronics, alcohol, drugs cigarettes, electronic inhaling devices and substances, or weapons of any kind.

 

Camp Christopher, Catholic Charities Diocese of Cleveland, Supplemental Consent, Release and Waiver of Liability

IN CONSIDERATION of the above named child (“Participant”) being permitted to participate in camp programming at Camp Christopher, a program of Catholic Charities Corporation, dba Catholic Charities Diocese of Cleveland, (“CCDOC”) the undersigned parent/legal guardian of Participant acknowledges that coronavirus ('COVID-19") infections have been confirmed throughout the United States, including in the State of Ohio and in Summit County, where Camp Christopher is located.

The undersigned hereby agrees, represents, and warrants that neither the undersigned nor Participant shall visit or utilize the facilities, services, and programs at Camp Christopher if he or she (i) experiences symptoms of COVID-19, including, without limitation, fever, cough or shortness of breath, or (ii) has a suspected or diagnosed/confirmed case of COVID-19. The undersigned agrees to notify Camp Christopher staff immediately if he or she believes that any of the above stated access/use restrictions may apply.

CCDOC and Camp Christopher have taken certain steps to implement recommended guidance and protocols issued by the Centers for Disease Control and Prevention (“CDC”) and the Ohio Department of Health (“ODH”) for slowing the transmission of COVID-19, including, without limitation, the access/use restrictions set forth above. The undersigned acknowledges and agrees that CCDOC may revise its procedures at any time based on updated recommended guidance and protocols issued by the CDC and ODH and further agrees to comply with the CCDOC’s revised procedures prior to utilizing the facilities, services, and programs of Camp Christopher and CCDOC.

The undersigned further acknowledges and agrees that, due to the nature of the facilities, services, and programs offered at Camp Christopher, social distancing of 6 feet per person among children is not always possible. The undersigned fully understands both the known and potential dangers of utilizing the facilities, services, and programs at Camp Christopher and acknowledges that the Participant may, despite the CCDOC's reasonable efforts to mitigate such dangers, result in exposure to COVID- 19, which could result in quarantine requirements, serious illness, disability, and/or death.

In further consideration of the undersigned consenting to and allowing Participant to participate in Camp Christopher programs, the undersigned, on behalf of him/herself and the Participant, their heirs, successors, representatives and assigns, forever RELEASE, WAIVE, DISCHARGE, HOLD HARMLESS Camp Christopher, CCDOC, the Diocese of Cleveland, the Bishop and/or Administrator of the Diocese of Cleveland, and the Diocese of Cleveland Facilities Services Corporation, each of their employees, members, directors, officers, volunteers, attorneys, representatives, and agents from any and all liability to the undersigned and/or Participant for any loss or damage, and any claim or demands on account of any property damage or any injury to, or an illness or the death of, the undersigned or Participant as a result of contracting COVID-19, or any related illness, infection or other viral, contagious, or infectious disease, either directly or indirectly, while the undersigned and/or Participant are in, upon, or about the premises or any facilities or equipment at Camp Christopher, or while participating in any program at or affiliated with Camp Christopher and/or CCDOC.

I HAVE CAREFULLY READ AND VOLUNTARILY SIGN THIS SUPPLEMENTAL CONSENT TO PARTICIPATE, RELEASE AND WAIVER OF LIABILITY.

I ALSO UNDERSTAND THAT THIS AGREEMENT IS MADE ON BEHALF OF MYSELF AND MY MINOR CHILD AND/OR LEGAL WARD, AND I REPRESENT THAT I HAVE FULL AUTHORITY TO SIGN THIS AGREEMENT ON BEHALF OF THE PARTICIPANT.

 

I have read and fully understand the contents of all the above grants of permission and releases of liability, numbered 1-7, and by my signature below, consent to the provisions of each of the Releases contained herein, collectively and individually.

IN WITNESS WHEREOF, I set my hands hereto as of the date set forth below:

Dated: April 18, 2024

 



First Participant Name

First Name*

Last Name*
First Participant Date of Birth*
First Participant Demographics
Participant Ethnicity*
Participant Religious Affiliation*
First Participant Signature*
Second Participant Name

First Name*

Last Name*
Second Participant Date of Birth*
Second Participant Demographics
Participant Ethnicity*
Participant Religious Affiliation*
Third Participant Name

First Name*

Last Name*
Third Participant Date of Birth*
Third Participant Demographics
Participant Ethnicity*
Participant Religious Affiliation*
Fourth Participant Name

First Name*

Last Name*
Fourth Participant Date of Birth*
Fourth Participant Demographics
Participant Ethnicity*
Participant Religious Affiliation*
Fifth Participant Name

First Name*

Last Name*
Fifth Participant Date of Birth*
Fifth Participant Demographics
Participant Ethnicity*
Participant Religious Affiliation*
Sixth Participant Name

First Name*

Last Name*
Sixth Participant Date of Birth*
Sixth Participant Demographics
Participant Ethnicity*
Participant Religious Affiliation*
Seventh Participant Name

First Name*

Last Name*
Seventh Participant Date of Birth*
Seventh Participant Demographics
Participant Ethnicity*
Participant Religious Affiliation*
Eighth Participant Name

First Name*

Last Name*
Eighth Participant Date of Birth*
Eighth Participant Demographics
Participant Ethnicity*
Participant Religious Affiliation*
Ninth Participant Name

First Name*

Last Name*
Ninth Participant Date of Birth*
Ninth Participant Demographics
Participant Ethnicity*
Participant Religious Affiliation*
Tenth Participant Name

First Name*

Last Name*
Tenth Participant Date of Birth*
Tenth Participant Demographics
Participant Ethnicity*
Participant Religious Affiliation*
Parent or Guardian's Email Address

Email*

Confirm Email*
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Additional Information
Household Income
Household Income*
****Special Dietary Information*****

Do you or your child have any special dietary needs?  If so, please contact Camp Christopher at campchristopher@ccdocle.org


Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*
Parent or Guardian's Date of Birth*
Parent or Guardian's Demographics
Participant Ethnicity*
Participant Religious Affiliation*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you 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.


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