Additional Forms for Application Process

P.O. Box 9 St. James, Mo. 65559 (573) 265-7445 800-748-7410 FAX (573) 265-5052 www.bibleimpact.org

I, the undersigned, am aware that during the adventure trips or activities described in this form and in which I am participating, under the arrangements of Whispering Winds Bible Camp and its parent organizations, Bible Impact Ministries, its agents, employees, and associates, certain risks and dangers may be present or occur, including but not limited to the outlined risks following;

I am aware that during the river trip in which I am participating under the arrangements of Whispering Winds Bible Camp, that certain risks and dangers may be present or occur, including but not limited to, hazards of traveling on a canoe or kayak with paddles, and other equipment on swift moving water, hazards of being on a tube, falls onto such equipment or into the river, swimming in the river, falls or slips while walking, hiking, or climbing on terrain that is not improved, participation in water activities, water fights, accidents, illness in remote places without medical facilities, injuries by reptiles, insects or other animals, the force of nature, and travel by automobile, van, bus, or other conveyance.

I am aware that during the rappelling trip, use of low element initiatives, or the climbing wall, in which I am participating under the arrangements of Whispering Winds Bible Camp, that certain risks and dangers may be present or occur, including but not limited to, hazards of falling from heights, rope entanglement, falling rocks and other debris, burns or other injuries related to the handling or use of ropes and other climbing equipment, falls or slips while walking, hiking, or climbing on terrain that is not improved, accidents or illness in remote places without medical facilities, injuries inflicted by reptiles, insects or other animals, the forces of nature, and travel by automobile, van, bus, or other conveyance.

I am aware that during the caving trip in which I am participating under the arrangements of Whispering Winds Bible Camp, that certain risks and dangers may be present or occur, including but not limited to, hazards of underground exploration in a cave, holes, crevices, and passageways, falling rocks and cave-ins, entrapments, falls or slips while walking, hiking, or climbing on terrain that is not improved, accidents or illness in remote places without medical facilities, injuries inflicted by reptiles, insects or other animals, the forces of nature, and travel by automobile, van, bus, or other conveyance.

I am aware that during the hiking, wilderness camping or backpacking trip in which I am participating under the arrangements of Whispering Winds Bible Camp, that certain risks and dangers may be present or occur, including but not limited to hazards of falls or slips while walking, hiking, or climbing on terrain that is not improved, accidents or injuries related to the use and handling of camping and backpacking equipment, accidents or illness in remote places without medical facilities, injuries inflicted by reptiles, insects, or any other animal, the forces of nature, and travel by automobile, van, bus, or other conveyance.

In consideration of and as part payments for the right to participate in such adventure recreation, other activities, use of recreational facilities, and the services and food, if any, arranged for me by Whispering Winds Bible Camp, its agents, employees, and associates, I have and do hereby assume all of the above hazards and other related risks which may be encountered on said adventure recreations including activities preliminary and subsequent thereto, and I do hereby hold Whispering Winds Bible Camp, its agents, employees, and associates harmless from any and all liability, actions, causes of action, debts, claims and demands of every kind and nature whatsoever which I now have or which may arise from, or in connection with my adventure recreation or participation in any other activities related thereto.

I hereby irrevocably consent to and authorize the use of and reproduction by Whispering Winds Bible camp, or anyone authorized by Whispering Winds Bible Camp, of any and all photographs which may be taken during the adventure recreation in which I am participating or other activities related thereto, for advertisement
or promotional purposes, without further compensation to me. All negatives and positives, together with the prints shall constitute property of Whispering Winds Bible Camp or those authorized by Whispering Winds Bible Camp to take pictures or videotapes, solely and completely.

I further agree to obey and follow all rules, regulations, and instructions of Whispering Winds Bible Camp, its agents, employees, and associates. The terms hereof shall serve as a release, indemnification, and assumption of risk for my heirs, executors and administrators and for all members of my family, including any minors accompanying me. This is a legally binding document, which I have read and understand. A Parent or Legal Guardian must give permission for all persons under the age of 18.

I hereby certify that I am the parent or the court approved legal guardian of the minor who has signed
above. I hereby grant such minor permission to participate in the adventure recreation and other activities
provided by Whispering Winds Bible Camp, and in such minor’s behalf, I hereby agree to all of the terms of the
RELEASE AND ASSUMPTION OF RISK FORM FOR ADVENTURE RECREATION printed above as if such
were fully written here.