Please read the guidelines below for adult leadership:

• Leaders, such as yourself, we be responsible for the wellbeing of youth participants from your
• church. This includes decisions about contacting the adults responsible for the child if medical or
• behavioral issues arise.
• It is the responsibility of leaders to have all medical information for their youth participants. The
• main group leader for the church should collect this information and make sure that it is available if
• needed throughout the event.
• Adult Leaders and chaperones should be above the age of 21
• Adult leaders should never be alone with youth, rule of three at all times.
• Leaders agree to model the respect and compassion of all participants, and will not make fun of
• parts of the retreat or student participants.
• Everyone in Tennessee is a mandated reporter under state law. Any person with reasonable cause
• to believe a child is being abused or neglected must, under the law, immediately report to the
• Tennessee Department of Children’s Services or to local law enforcement. The reporter can remain
• anonymous.
• In addition to reporting to the state, if a leader is to suspect neglect or abuse of a minor by a leader
• on the retreat, they should also report immediately to a presbytery representative.

Please read the guidlines below for adult leadership: Leaders, such as yourself, we be responsible for the wellbeing of youth participants from your church. This includes decisions about contacting the adults responsible for the child if medical or behavioral issues arise. - It is the responsibility of leaders to have all medical information for their youth participants. The main group leader for the church should collect this information and make sure that it is available if needed throughout the event. - Adult Leaders and chaperones should be above the age of 21 - Adult leaders should never be alone with youth, rule of three at all times. - Leaders agree to model the respect and compassion of all participants, and will not make fun of parts of the retreat or student participants. - Everyone in Tennessee is a mandated reporter under state law. Any person with reasonable cause to believe a child is being abused or neglected must, under the law, immediately report to the Tennessee Department of Children’s Services or to local law enforcement. The reporter can remain anonymous. - In addition to reporting to the state, if a leader is to suspect neglect or abuse of a minor by a leader on the retreat, they should also report immediately to a presbytery representative

I hereby give my permission to the Presbytery of East Tennessee/John Knox Center for me or my minor, child or ward (collectively “minor”) to participate in all activities and further agree to the terms herein contained. On behalf of my minor and/or myself, to participate in John Knox Center (hereinafter collectively referred to as JKC/ PET) activities and to use its equipment and facilities, I agree to release, indemnify, hold harmless, and covenant not to sue JKC/PET, its employees, agents or volunteers for any and all liability, claims, demands, or causes of action which may be brought by myself, my minor, or on behalf of either of us, and which are in any way connected with such use or participation by my minor or myself, whether caused by the negligence of JKC/PET, its employees, agents, or volunteers, or otherwise. I acknowledge that myself or my minor’s participation in individual and group initiatives, problem-solving exercises, high ropes elements, and personal growth and development training activities entails known, perceived, and unanticipated risks that could result in serious physical or emotional injury, permanent disability, or death. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity and I expressly accept and assume on behalf of myself and/or my minor all the risks existing in these activities. I authorize JKC/PET personnel to call for medical care or to transport myself or my minor to a medical facility or hospital if, in the opinion of such personnel, medical attention is needed. I agree to pay all costs associated with such medical care and transportation. I understand that every guest at the John Knox Center site is covered by secondary insurance, with the participant’s insurance being the primary party in claims situations. I also agree to comply with JKC/PET rules and policies and to cooperate with JKC/PET personnel. I understand and agree that if myself or my minor fail to comply with the rules and policies, s/he may be asked to leave the event at the parent or legal guardian’s expense, with no refund given for the paid cost of the event. I hereby represent that myself and/or my minor is in good health, that I have identified all medical conditions applicable to participation, and that I have adequately informed JKC/PET personnel of any special instructions. I certify that I have adequate insurance to cover any injury or damage my minor or I may suffer while participating, or I agree to bear the costs of such injury or damage myself. I give my permission to allow JKC/PET to use my likeness and/or my minor’s in photos and videos in any form of media for publicity and reporting purposes (print, digital, online, etc.). I agree that this release, waiver, and indemnity and other terms herein are intended to be as broad and inclusive as permitted by the law of the State of Tennessee and if any portion is invalid, the remainder shall continue in force. I understand that the Presbytery of East TN will do all in their power to mitigate the spread of COVID-19 and will ensure proper handwashing stations are available, however, by attending this retreat myself/ my minor is aware that exposure to COVID-19 is an inherent risk in any event where people are present; we cannot guarantee you will not be exposed during this event. I have read the above and acknowledge the information stated on this form is complete and correct. By signing or typing my name below, I agree that this wet inked or electronic signature is valid. I understand that an electronic signature is legally binding in Tennessee.