Section 1: Informed Consent, Assumption of Risk, and Release from Liability
This Agreement pertains to activities offered by Camp PossAbility, Inc., d/b/a PossAbility Unlimited (“PossAbility Unlimited” or the “Company”) at Bradford Woods in Martinsville, Indiana (the “Retreat”).
Participation, Activities, Risks, and WAIVER: I wish to participate in the Retreat. In consideration of my participation in the Retreat, I hereby agree to the following:
- I understand activities for the Retreat may include, but are not limited to, the following: ziplining, adapted ropes course, waterskiing, swimming, boating, outdoor sports, running, jumping, climbing, spending extended periods of time outdoors being exposed to the elements (sun, wind, rain, snow, ice) and consumption of food and/or beverages.
- I understand that certain risks are inherent in participation at the Retreat. These risks may include, but are not limited to, such things as incidents related to the above mentioned activities, including sprains, broken bones, cuts, bruises, entrapment, temporary or permanent disability, drowning, rope burn, and/or death; adverse weather conditions; exposure to theft and other criminal activity; allergic reactions to food and drink items; other physical, mental, and emotional injury; and other risks and dangers, whether known or unknown nor reasonably foreseeable.
- I shall be solely responsible for my own healthcare while participating in the Retreat activities. This includes any procedures or medication administration. I understand that if I require assistance during the Retreat, including but not limited to administration of medication, mobility assistance, or other assistance, I may have an aide attend the Retreat with me. The Company will not administer any medication or perform any procedures on my behalf. I have full permission to participate in the Retreat activities, and I am in good health.
- In case of an emergency, I understand that efforts will be made to contact the individual listed as the emergency contact person by the medical provider and/or the Company. In the event that this person cannot be reached, or time does not permit the person to be reached, permission is hereby given to the medical provider selected by the Company to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for me. Medical providers are authorized to disclose protected health information to the Company, the Company’s medical staff, management, and/or any physician or health-care provider involved in providing medical care to me. Protected Health Information/ Confidential Health Information (PHI/CHI) under the Standards for Privacy of Individually Identifiable Health Information, 45 C.F.R. §§160.103, 164.501, et. seq., as amended from time to time, includes examination findings, test results, and treatment provided for purposes of medical evaluation of me, follow-up and communication with my parents or guardian, if any, and/or determination of my ability to continue in Retreat activities. I authorize the sharing of my medical information with any Retreat volunteers or professionals who need to know of medical conditions that may require special consideration in conducting Retreat activities.
- I understand that any owners, employees, officers or agents of any attraction, enterprise or vendor of which I take part or participate during the Retreat, the other participants of Retreat (whether associated with the Company or not), and other third parties (collectively, “Third Parties”), are not the agents or employees of the Company and that dangers may be caused by the negligent or intentional act(s) or omissions of such Third Parties. I understand that the Company is not responsible for any injuries or property damage that may be caused by the acts or omissions of such Third Parties.
- I understand that my participation in the Retreat is entirely voluntary and at my own risk. I fully understand the scope of the activities and the potential risks involved in the Retreat. I agree to assume the risks of my participation in the Retreat, including the risk of catastrophic injury or death.
- I understand and agree that the Company does not provide insurance to cover medical expenses for injuries that may be sustained by me or for damage to my personal property, and that the Company strongly recommends that I carry my own health, medical, and property insurance for purposes of potential losses related to the Retreat.
- I HEREBY RELEASE AND FULLY DISCHARGE THE COMPANY, INCLUDING ITS OFFICERS, AGENTS, BOARD OF DIRECTORS, VOLUNTEERS AND EMPLOYEES, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION THAT MAY BE BROUGHT BY ME OR BY ANY OTHER PERSON (INCLUDING, BUT NOT LIMITED TO, MY ESTATE, FAMILY, SUCCESSORS, HEIRS, REPRESENTATIVES, ADMINISTRATORS, AND/OR ASSIGNS), INCLUDING ALL LIABILITY FOR DAMAGE TO PERSONAL PROPERTY (INCLUDING, BUT NOT LIMITED TO, DAMAGE TO WHEELCHAIRS, CANES, CRUTCHES AND OTHER PERSONAL MOBILITY EQUIPMENT), PERSONAL INJURY OR LOSS ARISING OUT OF OR RELATED TO MY PARTICIPATION IN THE RETREAT, WHETHER CAUSED BY THE COMPANY’S NEGLIGENCE OR OTHERWISE, TO THE FULLEST EXTENT PERMITTED BY LAW.
Media Release: I authorize the use, reproduction, and publication of photographs, videos, and recordings of me without limitation at the discretion of the Company and without any compensation.
Section 2: Service Animal Policy
In accordance with the Americans with Disabilities Act:
- Only service dogs trained to perform tasks for a disability are permitted and proof of a certified service animal shall be provided to the Company.
- Service dogs must be harnessed, leashed, or tethered unless impractical.
- Handlers must maintain control at all times.
- Dogs must be housebroken, immunized according to regulations, healthy, and clean.
- Service animals cannot be left alone at camp.
- Certain activities may be inaccessible to participants with service animals, including but not limited to: zipline, canoes, kayaks, high ropes course, horse barn, and swimming pool, as well as any other activity deemed inaccessible by PossAbility Unlimited.
The Company is not responsible for providing food, water, healthcare, supervision, or shelter for service animals.
Questions about service animals should be directed to Lauren Harmison at 260-415-6967.
Section 3: Medical Informed Consent
I acknowledge and consent to receiving certain medical treatments and procedures from independent health care providers during the Retreat.
These may include but are not limited to:
- Catheterization
- Bowel Procedure
- Medication Administration
- Skin Assessment (Full Body)
- Physical Assistance (bathing, toileting, feeding)
Participants may also engage in voluntary group discussions and educational activities that may include references to private or sensitive medical topics, such as catheterization or anatomy involving genitalia. These discussions are intended to promote shared understanding, empowerment, and health education among participants with similar care needs.
For the safety and appropriateness of care and discussion settings, participants must disclose their biological sex. PossAbility Unlimited respects every individual and is committed to maintaining a respectful environment for all.
I understand:
- That I am responsible to discuss this with my care provider and to complete the PossAbility Unlimited Medical Informed Consent form separately.
- The nature, benefits, and risks of the treatments and procedures.
- Alternatives to the treatments.
- No guarantees are made regarding outcomes.
- Health care providers are not employees of PossAbility Unlimited.
I have the right to ask questions, receive sufficient information, and withdraw consent at any time.
Section 4: Volunteer Acknowledgment (If Applicable)
If I am volunteering at the Retreat I also acknowledge and agree to the following:
- I understand I am not an employee of PossAbility Unlimited.
- I volunteer for personal, civic, charitable, or humanitarian reasons.
- I agree that I have no expectation to receive, nor do I seek, any compensation, benefits, or promise of future employment.
Section 5: Code of Conduct and Removal Policy
PossAbility Unlimited reserves the exclusive right to remove any participant or volunteer if, in its sole discretion, determines such removal is necessary for health and safety of its staff or participants.
Participants and volunteers may be removed from the Program and its premises who:
- Pose a threat to the safety or wellbeing of themselves or others.
- Violates policies, including service animal rules.
- Acts in a manner detrimental to the Retreat environment.
- Engages in inappropriate behavior or conduct that is, in the sole discretion of PossAbility Unlimited, disruptive, offensive, or inconsistent with the goals and values of the program.
- Fails to abide by their prescription medication.
Such removal may occur at any time, without prior warning, and at the sole discretion of PossAbility Unlimited.
Section 6: Exclusive Jurisdiction and Venue and Waiver of Right to Jury
Exclusive Jurisdiction and Venue: This Agreement shall be governed by and construed under the laws of Indiana. Notwithstanding any other agreement that I have signed related to the Retreat that purports to establish the venue for any litigation arising from the Retreat, I agree that I will file no action against the Company or its officers, employees, and agents, whether based on this Agreement or in any way otherwise connected to the Company, in any court other than the Circuit Court of Allen County, Indiana.
JURY WAIVER: I UNDERSTAND AND AGREE THAT ANY DISPUTE OR CLAIM ARISING OUT OF OR RELATING TO THIS AGREEMENT OR MY PARTICIPATION IN THE RETREAT SHALL BE RESOLVED IN A COURT OF LAW WITHOUT A JURY. I KNOWINGLY AND VOLUNTARILY WAIVE ANY RIGHT TO A TRIAL BY JURY IN ANY SUCH ACTION.
Acknowledgment and Signature
I have read this Agreement carefully, understand its contents, and agree to be bound by it.
I am at least 18 years of age, or my parent/legal guardian has also signed below.
Section 1: Informed Consent, Assumption of Risk, and Release from Liability
This Agreement pertains to activities offered by Camp PossAbility, Inc., d/b/a PossAbility Unlimited (“PossAbility Unlimited” or the “Company”) based primarily at Camp Owaissa Bauer, 17001 SW 264th St., Homestead, Forida, and including offsite travel within the state (collectively, the “Retreat”).
Participation, Activities, Risks, and WAIVER: I wish to participate in the Retreat. In consideration of my participation in the Retreat, I hereby agree to the following:
- I understand activities for the Retreat may include, but are not limited to, the following: ziplining, adapted ropes course, waterskiing, swimming, boating, outdoor sports, running, jumping, climbing, spending extended periods of time outdoors being exposed to the elements (sun, wind, rain, snow, ice) and consumption of food and/or beverages.
- I understand that certain risks are inherent in participation at the Retreat. These risks may include, but are not limited to, such things as incidents related to the above mentioned activities, including sprains, broken bones, cuts, bruises, entrapment, temporary or permanent disability, drowning, rope burn, and/or death; adverse weather conditions; exposure to theft and other criminal activity; allergic reactions to food and drink items; other physical, mental, and emotional injury; and other risks and dangers, whether known or unknown nor reasonably foreseeable.
- I shall be solely responsible for my own healthcare while participating in the Retreat activities. This includes any procedures or medication administration. I understand that if I require assistance during the Retreat, including but not limited to administration of medication, mobility assistance, or other assistance, I may have an aide attend the Retreat with me. The Company will not administer any medication or perform any procedures on my behalf. I have full permission to participate in the Retreat activities, and I am in good health.
- In case of an emergency, I understand that efforts will be made to contact the individual listed as the emergency contact person by the medical provider and/or the Company. In the event that this person cannot be reached, or time does not permit the person to be reached, permission is hereby given to the medical provider selected by the Company to secure proper treatment, including hospitalization, anesthesia, surgery, or injections of medication for me. Medical providers are authorized to disclose protected health information to the Company, the Company’s medical staff, management, and/or any physician or health-care provider involved in providing medical care to me. Protected Health Information/ Confidential Health Information (PHI/CHI) under the Standards for Privacy of Individually Identifiable Health Information, 45 C.F.R. §§160.103, 164.501, et. seq., as amended from time to time, includes examination findings, test results, andtreatment provided for purposes of medical evaluation of me, follow-up and communication with my parents or guardian, if any, and/or determination of my ability to continue in Retreat activities. I authorize the sharing of my medical information with any Retreat volunteers or professionals who need to know of medical conditions that may require special consideration in conducting Retreat activities.
- I understand that any owners, employees, officers or agents of any attraction, enterprise or vendor of which I take part or participate during the Retreat, the other participants of Retreat (whether associated with the Company or not), and other third parties (collectively, “Third Parties”), are not the agents or employees of the Company and that dangers may be caused by the negligent or intentional act(s) or omissions of such Third Parties. I understand that the Company is not responsible for any injuries or property damage that may be caused by the acts or omissions of such Third Parties.
- I understand that my participation in the Retreat is entirely voluntary and at my own risk. I fully understand the scope of the activities and the potential risks involved in the Retreat. I agree to assume the risks of my participation in the Retreat, including the risk of catastrophic injury or death.
- I understand and agree that the Company does not provide insurance to cover medical expenses for injuries that may be sustained by me or for damage to my personal property, and that the Company strongly recommends that I carry my own health, medical, and property insurance for purposes of potential losses related to the Retreat.
- I HEREBY RELEASE AND FULLY DISCHARGE THE COMPANY, INCLUDING ITS OFFICERS, AGENTS, BOARD OF DIRECTORS, VOLUNTEERS AND EMPLOYEES, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION THAT MAY BE BROUGHT BY ME OR BY ANY OTHER PERSON (INCLUDING, BUT NOT LIMITED TO, MY ESTATE, FAMILY, SUCCESSORS, HEIRS, REPRESENTATIVES, ADMINISTRATORS, AND/OR ASSIGNS), INCLUDING ALL LIABILITY FOR DAMAGE TO PERSONAL PROPERTY (INCLUDING, BUT NOT LIMITED TO, DAMAGE TO WHEELCHAIRS, CANES, CRUTCHES AND OTHER PERSONAL MOBILITY EQUIPMENT), PERSONAL INJURY OR LOSS ARISING OUT OF OR RELATED TO MY PARTICIPATION IN THE RETREAT, WHETHER CAUSED BY THE COMPANY’S NEGLIGENCE OR OTHERWISE, TO THE FULLEST EXTENT PERMITTED BY LAW.
Media Release: I authorize the use, reproduction, and publication of photographs, videos, and recordings of me without limitation at the discretion of the Company and without any compensation.
Section 2: Service Animal Policy
In accordance with the Americans with Disabilities Act:
- Only service dogs trained to perform tasks for a disability are permitted and proof of a certified service animal shall be provided to the Company.
- Service dogs must be harnessed, leashed, or tethered unless impractical.
- Handlers must maintain control at all times.
- Dogs must be housebroken, immunized according to regulations, healthy, and clean.
- Service animals cannot be left alone at camp.
- Certain activities may be inaccessible to participants with service animals, including but not limited to: zipline, canoes, kayaks, high ropes course, horse barn, and swimming pool, as well as any other activity deemed inaccessible by PossAbility Unlimited.
The Company is not responsible for providing food, water, healthcare, supervision, or shelter for service animals.
Questions about service animals should be directed to Lauren Harmison at 260-415-6967.
Section 3: Medical Informed Consent
I acknowledge and consent to receiving certain medical treatments and procedures from independent health care providers during the Retreat. These may include but are not limited to:
- Catheterization
- Bowel Procedure
- Medication Administration
- Skin Assessment (Full Body)
- Physical Assistance (bathing, toileting, feeding)
Participants may also engage in voluntary group discussions and educational activities that may include references to private or sensitive medical topics, such as catheterization or anatomy involving genitalia. These discussions are intended to promote shared understanding, empowerment, and health education among participants with similar care needs.
For the safety and appropriateness of care and discussion settings, participants must disclose their biological sex. PossAbility Unlimited respects every individual and is committed to maintaining a respectful environment for all.
I understand:
- That I am responsible to discuss this with my care provider and to complete the PossAbility Unlimited Medical Informed Consent form separately.
- The nature, benefits, and risks of the treatments and procedures.
- Alternatives to the treatments.
- No guarantees are made regarding outcomes.
- Health care providers are not employees of PossAbility Unlimited.
I have the right to ask questions, receive sufficient information, and withdraw consent at any time.
Section 4: Medical Marijuana and Smoking Policy
Smoke-Free Environment
The Company maintains a strictly smoke-free environment. Smoking, vaping, or burning of any substance—including tobacco, e-cigarettes, marijuana, or any other product—is prohibited at all times during the Retreat, including but not limited to:• All indoor and outdoor areas of Retreat venues;
- All vehicles owned, leased, or rented by the Company; and
- All lodging, meeting, and recreational spaces used for Retreat activities.
Use of Medical Marijuana
The Company recognizes that Florida law (Fla. Stat. § 381.986) permits the qualified medical use of marijuana by registered patients. However, to maintain the safety, comfort, and compliance of all participants:
- Any use of medical marijuana must be limited to edible form only.
- Smoking, vaping, or vaporizing marijuana is not permitted at any time.
- Participants must comply with all applicable Florida laws and venue restrictions.
- The Company does not provide, store, or administer marijuana in any form and does not endorse or facilitate its use.
Conduct and Safety
If the Company’s staff, volunteers, or agents determine that a participant’s use of marijuana, prescribed medication, or any other substance results in visible impairment, unsafe conduct, or disruptive behavior, the participant will be asked to leave the Retreat immediately.
- No refund, credit, or reimbursement will be issued.
- The participant may be deemed ineligible to attend future Retreats.
Federal Law and Other Jurisdictions
Participants acknowledge that marijuana remains a Schedule I controlled substance under federal law and is prohibited in Indiana and most other states. This Addendum does not authorize or permit any conduct that is unlawful under federal law or in any jurisdiction where the Company operates other retreats.
Medications and Disability Accommodations
This Policy does not restrict the lawful possession or use of prescription medications other than marijuana when used as prescribed by a licensed healthcare provider. The Company will make reasonable accommodations for disabilities in accordance with the Americans with Disabilities Act (ADA) and applicable state law, provided such accommodations do not compromise health, safety, or venue rules.
Acknowledgment and Agreement
By signing below, the Participant acknowledges and agrees to abide by this Medical Marijuana and Smoking Policy and understands that violation of this Policy may result in immediate removal from the Retreat.
Section 5: Volunteer Acknowledgment (If Applicable)
If I am volunteering at the Retreat I also acknowledge and agree to the following:
- I understand I am not an employee of PossAbility Unlimited.
- I volunteer for personal, civic, charitable, or humanitarian reasons.
- I agree that I have no expectation to receive, nor do I seek, any compensation, benefits, or promise of future employment.Section 6: Code of Conduct and Removal Policy
PossAbility Unlimited reserves the exclusive right to remove any participant or volunteer if, in its sole discretion, determines such removal is necessary for health and safety of its staff or participants.
Participants and volunteers may be removed from the Program and its premises who:
- Pose a threat to the safety or wellbeing of themselves or others.
- Violates policies, including service animal rules.
- Acts in a manner detrimental to the Retreat environment.
- Engages in inappropriate behavior or conduct that is, in the sole discretion of PossAbility Unlimited, disruptive, offensive, or inconsistent with the goals and values of the program.
- Fails to abide by their prescription medication.
Such removal may occur at any time, without prior warning, and at the sole discretion of PossAbility Unlimited.
Section 7: Exclusive Jurisdiction and Venue and Waiver of Right to Jury
Exclusive Jurisdiction and Venue: This Agreement shall be governed by and construed under the laws of Indiana. Notwithstanding any other agreement that I have signed related to the Retreat that purports to establish the venue for any litigation arising from the Retreat, I agree that I will file no action against the Company or its officers, employees, and agents, whether based on this Agreement or in any way otherwise connected to the Company, in any court other than the Circuit Court of Allen County, Indiana.
If a Court should deem that venue in Indiana is unenforceable as it relates to the Retreat, then this Agreement shall be construed so that this Agreement shall continue to be governed by and construed under the laws of Indiana, regardless of venue.
JURY WAIVER: I UNDERSTAND AND AGREE THAT ANY DISPUTE OR CLAIM ARISING OUT OF OR RELATING TO THIS AGREEMENT OR MY PARTICIPATION IN THE RETREAT SHALL BE RESOLVED IN A COURT OF LAW WITHOUT A JURY. I KNOWINGLY AND VOLUNTARILY WAIVE ANY RIGHT TO A TRIAL BY JURY IN ANY SUCH ACTION.
Acknowledgment and Signature
I have read this Agreement carefully, understand its contents, and agree to be bound by it.
I am at least 18 years of age, or my parent/legal guardian has also signed below.
