Name of attendee *

First Name

Last Name

Attendee is above 18 years of age *

Yes

No

If under 18, Name of parent or guardian

First Name

Last Name

Phone *

(###)

###

####

Liability release *

I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to release and hold harmless and defend the Spiritual Retreat Foundation, or any representatives associated with the scheduled event from all damages, claims, suits, expenses and payments for injury to my myself, child and/or property, including all damages, claims, suits, expenses and payments resulting from the negligence of the Spiritual Retreat Foundation, and/or their officers, directors, and employees.

I agree

Media Consent

I hereby assign and grant to the Spiritual Retreat Foundation (“SRF”) the right and permission to take, use, and publish photographs/films/videotapes/electronic representations/live-stream and/or sound recordings made of me or my child by or on behalf of SRF in connection with any event held at Sanctus Ranch Retreat Center, and I hereby release SRF from any and all liability from such use and publication. I hereby authorize SRF, at its sole discretion and without limitation as to time or place, to use for any purpose (including, without limitation, for promotional purposes), reproduce, sell, copyright, exhibit, broadcast, store electronically, and/or distribute said photographs/film/videotapes/electronic representations/live-stream and/or sound recordings, and I specifically waive any right to compensation that I or my child may have for any of the foregoing. I also agree to be placed on SRF’s mailing list to receive occasional emails from the organization.

I agree