Men’s Retreat 2024

MY INFORMATION

FIRST NAME:

LAST NAME:

DATE OF BIRTH:  

EMAIL:

STAY LENGTH:
Full WeekendSaturday Only

ACCOMODATION PREFERENCE:
CabinCampingSaturday Only - No accommodation needed

EMERGENCY CONTACT #1

DIETARY REQUIREMENTS

Special Dietary Requirements

MEDICAL INFORMATION

MEDICAL CONDITIONS:

INDEMNITY

Please read the following and indicate your agreement below:

• I understand that this is an adult retreat and I take full responsibility for my actions on it.

• I understand that I participate in all the activities at my own risk, and am responsible for undertaking all activities with appropriate safety measures in place.

• I understand that the church where applicable will take reasonable steps to provide a safe environment.

• I acknowledge that the church will not be liable for any injury that may be suffered which arises directly or indirectly either from, or in connection with, any activity I undertake.

• I hereby agree to indemnify and hold harmless Caringbah Baptist Church and any individual staff or voluntary leader against all claims arising out of any injury to myself, and the relevant activity being undertaken unless such injury results from a failure in the duty of care of Caringbah Baptist Church and any individual staff or voluntary leader.

• I authorise my emergency contact to be called if necessary and for an ambulance to be called on my behalf if required. I accept responsibility for payment of all expenses associated with any treatment I may receive.

Signature

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DATE: