Motor Vehicle Passenger Waiver ({{gravity-field-id-1}})


By signing this form, you are indicating that you have read and understood its contents and that you accept important legal obligations and waive legal rights.  Please clarify any concerns with the Camp Director before signing. This form must be signed and submitted to Lone Prairie Camp prior to being a passenger with an LPC Staff member driving (unless the driver is an immediate family member) or being a passenger in an LPC vehicle.

TO: Lone Prairie Camp, RR 1, Ferintosh, AB, T0B 1M0 ("LPC") RE: Involvement in Lone Prairie Camp event (The "Camp")


  • Camp Vehicles are defined as those motor vehicles which are owned and insured by LPC and to be used exclusively for the purposes of LPC;
  • Personal Vehicles are defined as those motor vehicles which are owned and insured by an individual or party other than LPC which may be used to transport individuals to and from the LPC premises;
  • "Camp Staff" is defined as those individuals (whether paid or volunteer) working for and under the direction of LPC and also those individuals serving in Christian Leadership Training (“CLT”) positions;
  • Only individuals who have completed the following may be granted permission to drive Camp Vehicles (“Designated Drivers”):
    • possess a valid driver’s licence;
    • necessary documentation (including a photocopy of their driver’s license);
    • have received insurance approval;
    • completed and agreed to abide by the contents of the LPC Motor Vehicle Driver Waiver; and
    • obtained parent/guardian permission where necessary by law
  • only Designated Drivers may drive Camp Vehicles;
  • all Camp Vehicles are to be used solely for the business and purpose of LPC;
  • the Driver understands and agrees that in the event that the Camp becomes aware of a Ticket (including parking tickets, photo radar tickets, etc collectively hereinafter “Ticket”) issued when the Driver was the Designated Driver, the undersigned will still be liable for the payment of the Ticket and any additional costs, charges or interest which may be incurred;
  • Designated Drivers are only allowed to transport other Camp Staff, except in extraordinary circumstances and with the direct permission of the Camp Director of LPC;
  • the Driver understands that it is a privilege to be a Designated Driver and at the sole discretion of the Camp Director of LPC this privilege can be removed.


I, the undersigned, give (referred to as the “Passenger”) permission to ride with another Camp Staff (see above definition) in their Personal Vehicle.


I, the undersigned, understand that LPC is not responsible nor will it undertake to ensure that there is proper or adequate insurance coverage for the Passenger in another’s Personal Vehicle.


I release, indemnify and hold harmless LPC, its trustees, directors, corporation members, staff, agents, volunteers, members and representatives from:
  1. any loss, personal injury, accident, misfortune or damage to the above named or his/her property, with the understanding that reasonable precautions shall be taken to ensure the health and safety of the above named;
  2. any claims, demands, actions and costs for any loss, injury, damage or expense whatsoever that might arise as a passenger of a Personal Vehicle;


I understand that this is a legal agreement that is binding upon myself, my heirs, executors, administrators, successors and assigns. I acknowledge that I have read and understand the terms of this agreement and acknowledge that by signing this agreement voluntarily, I am agreeing to abide by its terms and I am waiving certain legal rights that I or the Passenger may have. This Consent, Authorization and Acknowledgement shall be effective from and including up to and including .

Signature of Passenger (or Parent/Guardian if Passenger under 18)

Leave this empty:

Signature arrow sign here

Signature Certificate
Document name: Motor Vehicle Passenger Waiver ({{gravity-field-id-1}})
lock iconUnique Document ID: a8b03bc474db68d23085d62590b331024004d56f
Timestamp Audit
May 22, 2020 4:23 pm MDTMotor Vehicle Passenger Waiver ({{gravity-field-id-1}}) Uploaded by LPC Registrar - IP
May 22, 2020 4:42 pm MDT Document owner has handed over this document to 2020-05-22 16:42:44 -