On behalf of all persons mentioned on this form I accept full responsibility and indemnify the KBC personnel concerned with facilitating this event against any cost, damage or action for any medical, hospital and dental treatment necessary, and authorize the leaders facilitating the event to act on my behalf. I understand that the information collected on this form will be used only for the purposes of fulfilling the Kalgoorlie Baptist Church Duty of Care objectives for my family/myself and will be treated securely and not be passed on for commercial purposes.

Please note that children under 18 who would like to come to camp unaccompanied by their parent/guardian will need to get an indemnity form signed by their parent/guardian.

By checking this box you accept this Indemnity Statement.