Volunteer Service Statement & Agreement

I make this Statement and Agreement in order to provide, and to be authorized to perform, the following uncompensated adventure retreat services:

Programming: Expressive-Healing Arts/Snowshoe Hiking-Trail Hiking/Water Sports/Adventure Activities and Volunteer Activities under the direction of Cynthia E Cote, RN, APRN(R), PLLC Retreat Medical Director and staff for the duration of the chosen retreat.

In performing the specified volunteer service, I acknowledge the following:

• I am 18 years of age or older and know of no reason, medical or otherwise, which would prevent me from performing the tasks required;

• I have acquainted myself with what is required to perform those tasks, and represent that I have the skill and ability to perform them;

• I assume full responsibility for my own safety and the safety of others, and except where resulting from the negligence of the Retreat Medical Director and staff, I release and hold harmless Second Summit Retreats;

• Any and all claims of any nature for any illness, bodily injury or personal injury to me or damage to any property arising in any way from my participation in the above described activity, I further acknowledge that this release is binding upon my heirs, successors or assigns, that I have read the foregoing and understand its significance, and that I have executed this document voluntarily;

• I will perform the volunteer service in compliance with the standards and specifications established, or approved, by Cynthia E Cote, RN, APRN(R), PLLC Retreat Medical Director, and will honor the direction of Retreat officials to suspend or terminate services.