THE DETAILS A nonrefundable deposit of $150 is due at registration.

Deposits are due & Registration closes March 31, 2019

(All payments are considered a contribution to the church

and therefore are non-refundable.)

All forms and final payments MUST be turned in by

June 1, 2019.

Please complete the following forms and register online:

2019 Grace Missions Covenant

2019 Grace Waiver

SIFAT Medical Release

Whitewater Express Waiver

SIFAT

SIFAT is a Christian organization

that exist to help people from

different countries, cultures and

social classes understand each

other and work together, so that

every person can have a chance

to develop into the person God

intends for each to be. The

SIFAT team desires to bring the

Kingdom of God closer to all.

https://sifat.org/

THE TRIP

This year we are combining

middle school and high school

to take over one of SIFAT’s Learn

& Serve Experience weeks. We

will learn how to think globally

and act locally, while learning

about poverty around the world

and simple solutions to world-

wide problems. We will also

have the opportunity to serve

the local community of Lineville.

All while enjoying the beautiful

SIFAT grounds.

COST : $464.50

includes transportation,

housing, most meals, t-shirt, and

a whitewater adventure.

LINEVILLE, AL June 22-29, 2019 // Grace Student Ministries // Mission Trip

THE TRIP AT A GLANCE

SIFAT’s 2019 theme is ‘Bloom’. We will discover how to walk with the Lord to bloom personally and within

our communities for His glory and our good.  We will also

have the opportunity to spend time with SIFAT graduates

from Congo and Uganda to learn about the specific

needs in their regions and what God is doing through His

people to meet them.

We will spend the first two days of the week immersed in

the rural villages and foreign cities through a global

village and slum simulation experience. This means we

will be camping for two nights of the week.

During the second half of the week, we will join with SIFAT

graduates from AdapTech and participate in hands on

workshops that teach about clean water, farming and

gardening techniques, appropriate technology, and even

edible bugs. We will also have the opportunity to pick

blueberries from the on-site blueberry bushes.

Most importantly, we will start each day together with the

Lord in devotion and close out each night with dynamic

worship, storytelling, Bible study, small groups, and even

some games. We will conclude our time at SIFAT by

serving in the community of Lineville and will celebrate

with a cookout made by SIFAT’S farm to table interns.

After an amazing week at SIFAT, we will make our way back

to Houston with a stop at Whitewater Alabama in Phenix

City where we will raft the Chattahoochee River. A rafter’s

paradise, this section of the Chattahoochee was designed

and built in 2013 to offer custom trips ranging from mild

to wild. We will float, paddle, and splash our way through

Class I-IV rapids and are certain to have a fantastic time.

You don’t want to miss this Summer Experience!

LINEVILLE, AL

COST & FUNDING

The total cost of this trip per person, including; transport, room and board, food, t-shirt, and fun day is

$696.75. As with past years, we expect to raise one-third of the cost of this trip through our Student

Mission Sunday Silent Auction and Clay Shoot Fundraiser. This event will take place on Sunday, March 31,

2019. All students who plan to attend the mission trip should be available to assist on that day during the

Sunday services and at the luncheon.

The student is responsible for $464.50. We strongly encourage the students to raise one-half of this

amount ($232.25) by writing letters to family and friends. A sample fundraising letter is attached to this

packet. We believe writing letters encourages the student’s community to support them both prayerfully

and financially, and invest in the work they are doing and the work God is doing through these trips.

A non-refundable deposit of $150 is due at registration. Payment must be received in order to

guarantee a spot on trip. Registration and deposit DUE March 31, 2019. We have to give final

numbers and payments to SIFAT by April 1, 2019. You have until June 1 to turn in all forms and final

payments. All payments for the Mission Trip are considered a contribution to church and therefore

are non-refundable.

We never want cost to be a reason a student cannot attend an event, limited scholarships are available.

Please contact Lindsey for scholarship qualifications and the scholarship application.

Total Cost per Participant ………………………………….……$696.75

1/3 Covered by Student Mission Sunday Fundraiser …………$232.25

1/3 Student Responsibility …………………………………….$232.25

1/3 Support from Family & Friends …………………………..$232.25

HOUSING & ACCOMMODATIONS

We will be staying at the beautiful facilities located on SIFAT’s 176-acre farm in Lineville, AL. Their address

is 2944 County Road 113, Lineville, AL 36266

• The Lodge which sleeps 75 ( 2 bunk rooms & 4 suites). Each bunk room and suite has their own

bathroom with multiple showers and stalls. Large meeting space and a porch overlooking the creek.

• The International House which sleeps 26 (4 suites, each with own bathroom)

There are photos of the Lodge’s and International House’s sleeping accommodations and large meeting

room on the following page. Also check SIFAT’s website sifat.org or find them on Facebook, @sifatbook for

more photos of their acreage.

LINEVILLE, AL

HOUSING & ACCOMMODATIONS CONT.

Bunkroom in the LodgeLarge Meeting Room in the Lodge

Suite in International House

Outdoor Chapel

LINEVILLE, AL

SIFAT Farm View

SCHEDULE OVERVIEW

Saturday, June 22, we will meet at Grace Presbyterian Church @ 9:00 PM to check-in and load up the

buses. We will depart for Lineville, Alabama at 10:30 PM

Sunday, June 23, we will arrive at SIFAT at 1 PM after stopping for breakfast and lunch on the road. We will

check-in unload and settle in. We will meet the SIFAT staff and interns who will give us an orientation.

Sunday afternoon - Friday morning we will be on-site at SIFAT

Friday, June 28, we will load up the buses and head back to Houston at 10:30 AM stopping at 12:00 PM in

Phenix City, AL to enjoy some whitewater rafting.

Saturday, June 29, we will arrive back in Houston at Grace Presbyterian Church at 7:00 AM

MEALS

While at SIFAT all of our meals will be provided by them. This will be some of the most fresh and delicious

camp food, as SIFAT is a working farm. Please let us know if your child is allergic to any foods, so we can

share this info with SIFAT.

*Students will be responsible for 4 meals on the road (1 breakfast, 2 lunches, 1 dinner).

EXTRA SPENDING MONEY

Students will be responsible for 4 meals on the road (1 breakfast, 2 lunches, 1 dinner). The places we will

stop will be inexpensive.

We recommend providing your student with about $40-45 for meals and snacks on the road. The students

can also bring their own snacks.

MEDICINE POLICY / HOSPITAL INFORMATION

• If your child has a prescription medication or needs an over-the-counter medicine during the extent of

the trip, please enclose in a plastic bag with student’s name and dosage amount/times/etc. and turn in at

Check-In. We will have a nurse or volunteer leader in charge of making sure students take their

medications accordingly.

• The closest hospital to SIFAT is located about 20 minutes away in Ashland, AL. — Clay County Hospital /

83825 Highway 9, Ashland, AL 36251 / 256-354-2131

LINEVILLE, AL

SIFAT Sample Daily Schedule

DAY TIME ACTIVITY

SUNDAY 2:00 PM Students arrive/ Get to know you games

3:00 PM Orientation and Staff Introductions

3:30 PM Meet & Greet Games w/ Family Groups and Adult Meeting

4:15 PM Prepare for Hike

4:45 PM Meet with Family Groups / Hike to Global Village

5:00 PM Global Village Experience

5:30 PM Dinner

6:45 PM Speaker/Worship

7:30 PM Devo & Global Village Experience Continued

MONDAY 8:00 AM Breakfast

9:00 AM Global Village Tour

11:00 AM Urban Poverty Experience

5:30 PM Debrief Family Group Time

6:30 PM Dinner

7:30 PM Worship

TUESDAY 8:00 AM Breakfast

group will be divided

in half on Tues. and

Wed. with half of the

group following

Tuesdays Schedule

and the other half

following

Wednesdays

Schedule and then

switch.

8:30 AM Devo

9:00 AM walk to North Farm

9:35 AM App-Tech @ North Farm

12:00 PM Lunch

1:00 PM App-Tech @ North Farm

6:00 PM Dinner

7:30 PM Back at base camp

8:30 PM Worship and Devo

WEDNESDAY 7:15 AM Blueberry Picking Group 1

8:00 AM Breakfast

8:30 AM Devo

9:00 AM Family Group Time

9:30 AM Challenge Course

12:00 PM Lunch

1:00 PM Rotating Learning Stations

3:15 PM Free Time

6:00 PM Dinner

7:30 PM Worship/Devo/Family Group Time

THURSDAY 7:15 AM Blueberry Picking Group 2

8:00 AM Breakfast

9:15 AM Family Group Time

10:00 AM Depart for Community Sites in Lineville

2:00 PM Leave Community Sites

4:00 PM Soccer Cookout with Lineville community

7:30 PM Worship/Devo/Family Group Time

FRIDAY 7:15 AM Blueberry Picking Group 3

8:00 AM Breakfast

8:30 AM Outdoor Devo

9:00 AM Clean Lodging

9:45 AM Village Store Open

10:00 AM Depart for Home

�1

WHITE WATER ADVENTURE

On our way back to Houston we will stop at Whitewater Alabama located in Phenix City and go on a

guided raft adventure along the Chattahoochee River. This is a great place for all skill levels, whether it is

your first time on a whitewater raft or you have been on multiple trips you are sure to enjoy this

experience!

whitewateralabama.com/rafting

ADULT CHAPERONES AND LEADERSHIP

Grace Student Ministries has been blessed with an abundance of leaders who have a desire to walk

alongside students and point them to their Savior and Creator. Because safety, health, spiritual growth, and

the well-being of our students is extremely important to us, we require 1 leader for every 5 students who

attend this trip. Each of our leaders are required to go through numerous background checks, successfully

complete an ECO training program, and much more. We are extremely thankful for the dedication and

hard work that our leaders give to the ministry and our students!

CELL PHONE POLICY

Students are allowed to bring cell phones. They will be allowed to have them on the travel days. Once we

arrive at SIFAT (Sunday afternoon - Friday morning) leaders will collect everyone’s phones. Cell

Service is extremely limited at SIFAT. When the leadership team did a site visit, we experienced losing

cell phone service while on location.

If you need to get a hold of your child while at SIFAT, please call one of the Grace staff leaders’ cell

phones or the SIFAT main office: (256) 396-2015

GRACE CONTACT INFORMATION PRIOR TO TRIP

Lindsey McDonald Monica Cvejanovich

713-267-5067 713-267-5011

lmcdonald@gpch.org mcvejanovich@gpch.org

LINEVILLE, AL

PACKING LIST *

• Radios, iPads, Tablets, Electronic Games, TVs, etc.

• Anything that is not replaceable or has significant value, like expensive jewelry or laptops. DO

NOT BRING A LOT OF MONEY OR VALUABLES.

• Drugs, alcohol, vapes, juules, knives, guns, weapons of any kind, etc. If a student is caught with

any of these in his/her possession, the item(s) will be confiscated and the student’s parents will

be contacted. The student will be sent home immediately at the parent’s expense.

LINEVILLE, AL

PERSONAL ITEMS:

• Personal Medications (will be given to an adult leader at check-in and distributed as needed.)

• Aloe Vera Gel

• Bandana

• Bath Towel

• Beach Towel

• Washcloth

• Wet wipes

• Toothbrush

• Toothpaste

• Brush

• Soap

• Deodorant

• Shampoo/Conditioner

• Laundry Bag

• Work gloves

• Blanket for bus

• Snacks for Bus

• Extra Spending Money for meals on the road (around $40)

MUST HAVES:

Bible/Journal/Pen

Water bottle

Hat/Baseball Cap

Sleeping bag for camping 2 nights

twin sheets for mattress

Pillow

Bug Spray!!!

Sunscreen!!!

CLOTHING:

• Camp clothes (Athletic Shorts - NO Lululemon shorts - T-shirts - NO tank tops)

• 1 pair of jeans

• Pajamas

• Comfortable travel clothes for bus ride

• Swimwear (girls modest one-piece / boys no speedo)

• Water Shoes for rafting

• Flip-flops / Shower shoes

• Tennis Shoes - Closed toe for

DO NOT BRING

Sample Support Letter

Dear ______________________,

From June 22-29, I have the opportunity to travel to Lineville, Alabama with Grace Presbyterian Church’s

Student Ministries. We will participate in a week long Learn & Serve Mission Experience led by a

Christian missions training organization,

Servants in Faith and Technology (SIFAT). SIFAT

exist to help people from different countries,

cultures and social classes understand each

other and work together, so that every person

can have a chance to develop into the person

God intends for each to be. They desire to

bring the Kingdom of God closer to all.

While at SIFAT, our group will learn how to walk

with the Lord to bloom personally and within

our communities for His glory and our good. We will have time to spend with SIFAT graduates from

Congo and Uganda to learn about specific needs in their regions and what God is doing through His

people to meet them. We will also have the opportunity to learn about and serve in the local community

of Lineville. Most importantly, we will start each day together with the Lord in devotion and close out

each night with worship, storytelling, Bible study, and small groups. At the end of this experience, our

group hopes to return to our community with an understanding of what it means to think globally and

act locally, and to have shared in an experience that will renew in us an excitement about the restorative

work Jesus Christ is doing in the world and in our lives, and the invitation to be a part of this work of

restoration.

I would like to invite you to consider partnering with our group, first through prayer. Please

consider praying for this mission experience. Pray for the group - that we would be open to learning

from the community we are visiting and grow closer as a group and closer to Jesus. Pray for the staff and

leaders who will be leading us during the trip. Pray for the people in the community who we will meet -

that we could love and honor them well. Finally, pray for me — that I could keep an open heart to the

people around me and to how God is revealing himself to me during the week. Please let me know, if

you will commit to praying for us. I would love to share that news with my group.

Secondly, I would invite you to please consider partnering with our group financially. Each person

on our team has been asked to raise $232.25. If 5 people gave $26.45, 4 people gave $25. I would

reach my goal. That being said, I am grateful for any amount you may feel led to give. If you would like

for your gift to be tax-deductible, please make the check out to “Grace Presbyterian Church.” Please

mail all financial gifts to:

[STUDENT NAME]

[STUDENT ADDRESS]

Thank you for considering supporting us through prayer and/or giving. This trip would be impossible

without the generosity of so many. I am excited for this opportunity, and I look forward to sharing about

this experience with you when I return.

Sincerely,

[STUDENT NAME]

2019 GRACE MISSIONS COVENANT

1 CORINTHIANS 10:31: Therefore, whether you eat or drink, or whatever you do, do all to the glory of God.

I UNDERSTAND THAT BY SIGNING THIS COVENANT, I AGREE TO ABIDE BY ALL RULES OR RISK BEING SENT HOME AT PARENT’S EXPENSE:

ACTIONS CONSEQUENCE

Purchase, consumption or possession of any vapes/juules, smoking/ Sent home at parents’ expense tobacco products, alcohol, or any non-alcoholic frozen drinks, (call/taxis/extra flight, etc.) weapons, or drugs.

Guys & Gals: It is important that we stay above reproach and hold ourselves Sent home at parents’ expense to a high standard when it comes to our interaction with the opposite sex. We need your help in avoiding any situations that may be perceived as inappropriate. - No opposite gender in your room at any time

Clothing: Our goal is to be as modest as possible for the culture Confiscate clothing we will serve and for our group’s goal. - No short shorts for any reason. - Please wear regular t-shirts with full sleeves. - One-piece modest bathing suits only. No spaghetti straps, tummy baring, or immodest clothing for the night. - If you question an item of clothing—don’t bring it.

Electronics: We want to spend this week focusing on the service Confiscate item for length of trip and people God has put before us. Please leave the following at home:

- iPads, tablets, PSP, MP3 players, CD players, etc

Sleep and Meals: We’ve got to eat and rest in order to maintain our stamina and health while serving. Both are vital on our trip. Verbal warning - Everyone is expected to eat 3 meals each day. Meeting with staff/leaders - Respect your roommates’ and the groups’ need for rest

Showing Respect: Please show respect by listening when others are talking; Verbal warning whether it’s one of our new friends, leaders, or friends. Meeting with staff/leaders

- Refrain from gossiping or abasing others. Sent home at parents’ expense - No FOUL LANGUAGE

Damage to Accomodations/Buses, etc: We need your help in respecting and honoring You will pay for the damages and the places we get to stay and use. Remember you are representing yourselves, your family, be sent home at parents’ expense. Grace Church, and Jesus Christ. - All facilities should be left clean and in order. Staff/Leader Responsibilities: It is our job to help protect and care for you on this trip. - At all times, Grace staff has the authority to modify or implement the covenant to fit the needs of different circumstances that may arise

Student Responsibilities: Along with keeping the covenant yourself, we expect that you help everyone stay accountable to the covenant In confidence, we expect that you will inform a leader if you become aware of the covenant being broken. By not reporting covenant infractions you jeopardize: the safety of the group, the leaders, and risk being seen as associated or a participant in the infraction.

________________________________________________________________ _____________________ Parent’s Signature Date

_________________________________________________________________ _____________________ Student’s signature Date

_______________________________________________________________________ Printed Name of Student

2019-2020PERMISSIONSLIP,WAIVER,MEDICALAUTHORIZATIONANDRELEASE

NameofStudent_________________________________________________HomePhone____________________

Address_______________________________________________________________________________________

City______________________________________________State______________________Zip______________

Studentemailaddress___________________________________________________________________________

Parentemailaddress____________________________________________________________________________

Parent(s)and/orLegalGuardian(s)_________________________________________________________________

Cell/Pager/WorkNumbersofParent(s)and/orLegalGuardian(s)__________________________________________

_____________________________________________________________________________________________

AgeofChild:_____BirthDate:_____________Gender:_____Grade:_____School:________________________

FUNCTIONSANDACTIVITIES

ItismyunderstandingthatparticipatingintheprogramsandrecreationalandotheractivitiesofGracePresbyterian

Church(“theChurch”)isaprivilege.Priortomystudent’sparticipationinsuchactivities,Iacknowledgethatcertainrisksare

associatedwiththeactivities,including,bywayofexample,physicalinjuryduetoactivityrelatedaccidents,physicalinjury

duetotransportationrelatedaccidents,illnessorevendeath.Inaddition,Iacknowledgethattheremaybeotherrisks

inherentintheseactivitiesofwhichImaynotbepresentlyaware.Theundersignedherebygiveourconsenttoand

authorizetheminorchildnamedabovetoparticipateinalleventsconductedbytheChurch.Ifurtherauthorizemyminor

childtotravelwithrepresentativesoftheChurchinprivateorothervehiclestoanysucheventssoconducted.

PUBLICITY

Onoccasion,theChurchtakesphotographsormakesanaudioorvideotaperecordingofstudentsand/oradultsinvolvedin

churchactivities.Suchphotographsorvideorecordsmaybeusedbystaffandparticipantstoremember

theactivitiesandparticipants.Inaddition,suchphotographsandaudio/visualrecordingsmaybeusedinGrace

PresbyterianChurchpublicationsoradvertisingmaterialstoletothersknowaboutourministry.Inaddition,localnews

organizationsmayhearofouractivitiesorevents,andourChurchmayallowthemtophotographorrecordoureventsfor

newsreportingonspecialinterestfeatures.

Iconsenttotheuseofanysuchaudioorvisualrecordofthechildnamedabovetobeused,distributed,or

displayedasagentsoftheChurchseefit.Thisconsentincludesbutisnotlimitedto:photographs,videotape,audio

recordings,andtheChurch’swebpage.____Yes___No

Continuedonbackside…..

FIRSTAIDANDEMERGENCYMEDICALTREATMENT

Irecognizethattheremaybeoccasionswhenthestudentnamedabovemaybeinneedoffirstaidoremergencymedical

treatmentasaresultofanaccident,illness,orotherhealthconditionorinjury.Idoherebygivepermissionforagentsofthe

Churchtoseekandsecureanyneededmedicalattentionortreatmentforthestudentnamedincludinghospitalization,ifin

theopinionoftheagentsuchaneedarises.

Further,IauthorizetheagentoftheChurchtoconsenttoanyX-rayexamination,anesthetic,medicalorsurgicaldiagnosisor

treatmentandhospitalcarewhichisdeemedadvisableby,andisrenderedunderthegeneralorspecialsupervisionof,any

physician,surgeon,ordentistlicensedunderthelawsoftheStateorCountyinwhichthemedicalcareisbeingsoughtand

onmedicalstaffofanyhospital.IndoingsoIagreetopayallfeesandcostsarisingfromthisactiontoobtainmedical

treatmentincludinganytreatmentaphysician,surgeon,ordentistmaydeemnecessary.

RELEASEOFLIABILITY

Bysigningthisform,Iexpresslywarrantthatthestudentnamedaboveiscapableofwithstandingboththephysicaland

mentaldemandsoftheactivitiesdiscussedabove.Ialsoexpresslyassumeallrisksofthechildparticipatingintheactivities,

whethersuchrisksareknownorunknowntomeatthistime.I,theundersigned,formystudent,mystudent’spersonal

representatives,assigns,heirs,distributees,guardians,andnextofkin(“theReleasors”),herebyirrevocablyand

unconditionallyrelease,waive,discharge,andcovenantnottosuetheChurchanditsministers,leaders,employees,

volunteers,andagents,forandfromallclaimsofanynaturenoworhereafterexistingwhetherknownorunknown,

includingbutnotlimitedto,allliabilitytotheReleasors,onaccountofinjurytomychildordeathtomychildorinjurytothe

propertyofthechild,whethercausedbythenegligenceoftheChurch,itsministers,leaders,employees,volunteers,and

agentsorotherwise,duringthecourseofmystudent’sparticipationintheactivities,arisingoutoforin

connectionwithactivitiesrelatedtotheChurch,oranytravelconnectedtherewith.

MEDICALHISTORY

Specialmedicalneedsorconcerns(allergies,conditions,dietaryneeds,medications,etc.):________________________________________________________________________________________________________

________________________________________________________________________________________________________

________________________________________________________________________________________________________

HealthInsurance

InsuranceCompany_________________________________________PhoneNumber____________________PolicyNumber_________________

MedicalDoctor_______________________PhoneNumber_______________DateofLastTetanusShot_________

Intheeventthatparent(s)and/orlegalguardian(s)cannotbereached,call(Name&PhoneofEmergencyContact):

________________________________________________________________________________________________________

OtherInformation

Otherinformationchurchleadersshouldknowaboutthechild

________________________________________________________________________________________________________

PARENTORGUARDIANSIGNATURE

IrepresentthatIamtheparent/guardianof________________________________,whoisunder18yearsofage.Ihavereadtheabove

formandamfullyawareofthecontentsthereof.Igivepermissionforthestudentnamedabovetoparticipateinthe

activitiesofGracePresbyterianChurch,includinganyspecialevents/activities.Inconsiderationforallowingthe

participationofthestudentintheactivitiesoftheChurch,Iherebyconsenttotheabovetermsonbehalfofthechildand

agreethatthisformshallbebindinguponme,myfamily,heirs,legalrepresentatives,successors,andassigns.

_______________________________________________________________________________________________________

SignatureofParentorLegalGuardian Date

________________________________________________________________________________________________________

PrintNameofParentorLegalGuardian

YOUNGPERSON’SAGREEMENT

IagreetoparticipateinthefunctionsandactivitiesoftheChurch,tocooperatewiththeleadersandotheryoungpeople,and

toconductmyselfaccordingtoChristianvalues.IpromisetorespectGod,respectmyself,respectotherpersons,andrespect

property.Iunderstandthatmycontinuedparticipationinchurchactivitiesdependsonmysupportofthisagreement.

_________________________________________________________________________________________________________

Student’sSignature Date

Individual Student Medical Release Form

SIFAT does not insure visitors/participants and is not responsible for any bodily injury that may occur during time spent on SIFAT property.

Group Name _______________________________________________________________________ Participant’s name______________________________________ Gender ________ Age:_____

Parent or legal guardian _________________________________________________________________________________

Address______________________________________________________________________________________________

_____________________________________________________________________________________________________

Phone number: day_____________________________ night_____________________________

Emergency contacts:

Name_________________________________________________________________________________________

Relation to participant____________________________________________________________________________

Phone number: day___________________ night__________________________________________________

Name__________________________________________________________________________

Relation to participant_____________________________________________________________

Phone number: day___________________ night___________________________________

Physician______________________________________________________________________________

Physician’s Phone ________________________________________________________________________

Insurance agency _____________________________________________________________

Policy Number, Policy Holder Name & DOB______________________________________________________________

Known allergies:_________________________________________________________________________

Medication(s):___________________________________________________________________________

_____________________________________________________________________________________________________

_____________________________________________________________________________________________________

Special needs: _________________________________________________________________________________________

Dietary needs: _________________________________________________________________________________________

I, ______________________________ (parent/legal guardian), hereby acknowledge that SIFAT is not responsible for any

injury my child may incur during his/her time spent at SIFAT. I further release from any liability SIFAT and its Staff and/or

leadership in the event of any accident. I also give my child permission to take part in creek and lake activities, which are

a part of the Learn & Serve program. I authorize _________________________ (group leader) to seek appropriate

medical attention if needed.

________________________________________

(Signature of parent/legal guardian)

__________________________________

(Date)

CHATTAHOOCHEE RAFTING COMPANY, INC.

DBA WHITEWATER EXPRESS

Waiver and Release of Liability Name: __________________________________ Age: ____________ Gender: M / F (circle one) Group Name: ____________________________ Group Leader: ____________________________ Date(s) of stay at WhiteWater Express: _____________________

In Consideration of Chattahoochee Rafting Company, Inc. furnishing services and/or equipment to enable me to participate in rafting, ropes course, horseback riding, mountain biking, canoeing, kayaking, camping, tubing, and other activities, I agree as follows:

I fully understand and acknowledge that outdoor recreational activities have (a) inherent risks, dangers, hazards, and such exist in my use of Chattahoochee Rafting Company, Inc. equipment and my participation in such activities; (b) my participation in such activities and/or use of such equipment may result in injury or illness including, but not limited to, bodily injury, disease, strains, fractures, partial and/or total paralysis, death or other ailments that could cause serious disability; (c) these risks and dangers may be caused by the negligence of the owners, employees, officers, or agents of Chattahoochee Rafting Company, Inc., Uptown Whitewater Management L.L.C., Columbus Consolidated Government, Georgia Power, Phenix City Alabama and the United States; the negligence of the participants, the negligence of others, accidents, breaches of contract, the forces of nature, or other causes. Risks and dangers may arise from foreseeable or unforeseeable causes including, but not limited to, guide decision making, including that a guide may misjudge terrain, weather, trail or river route location, and water level, risks of falling out of or drowning while in a raft, canoe, or kayak and such other risks, hazards, and dangers that are integral to recreational activities that take place in a wilderness, outdoor, or recreational environment; and (d) by my participation in these activities and/or use of equipment, I hereby assume all risks and dangers and all responsibility for any losses and/or damages whether caused in whole or in part by the negligence or other conduct of the owners, agents, officers, or employees of Chattahoochee Rafting Company, Inc., Uptown Whitewater Management, L.L.C., Columbus Consolidated Government, Georgia Power, Phenix City Alabama or the United States, or by any other person. In addition, I hereby grant permission to Chattahoochee Rafting Company, Inc. to make and use for promotion or other purposes, photographic records without recourse or compensation to me.

I, on behalf of myself, my personal representatives, and my heirs hereby voluntarily agree to release, waive, discharge, hold harmless, defend, and indemnify Chattahoochee Rafting Company, Inc., the Uptown Whitewater Management, L.L.C., Columbus Consolidated Government, Phenix City Alabama and the United States, and its owners, agents, officers, and employees from any and all claims, actions, or losses for bodily injury, property damage, wrongful death, loss of services, or otherwise which may arise out of my use of Chattahoochee Rafting Company, Inc. equipment or my participation in Chattahoochee Rafting Company, Inc. activities. I specifically understand that I am releasing, discharging, and waiving any claims or actions that I may have presently or in the future for the negligent acts or other conduct by the owners, agents, officers, or employees of Chattahoochee Rafting Company, Inc., the Uptown Whitewater Management, L.L.C., Columbus Consolidated Government, Phenix City Alabama and the United States.

The venue of any dispute that may arise out of this agreement or other-wise between the parties to which Chattahoochee Rafting

Company, Inc. or its agents is a party shall be either the Phenix City, Alabama Justice Court or State Supreme Court in Russell County Alabama.

I HAVE READ THE ABOVE WAIVER AND RELEASE. BY SIGNING IT, I AGREE IT IS MY INTENTION TO EXEMPT AND

RELIEVE CHATTAHOOCHEE RAFTING COMPANY, INC., UPTOWN WHITEWATER MANAGEMENT, L.L.C., COLUMBUS

CONSOLIDATED GOVERNMENT, GEORGIA POWER, PHENIX CITY ALABAMA, AND THE UNITED STATES FROM

LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE, OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR

ANY OTHER CAUSE.

Signature: _______________________________ Date: ____________ Parent/Guardian Signature (if under 18): _______________________________ Date: ____________