Release

Thank you!

We are so excited to see you at L7 Surf Camp! Just a few steps left to get you on your way. Please read the following and complete all three forms needed to attend camp.

View, download and complete each form. Then scan each completed form and return to this page to upload them to L7surf management.

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Aloha Parent or Guardian,

My name is Evan Rogers and as one of the founders of Lucky Sevan, we are privileged to extend an invitation to your youth to participate in our Youth Leadership Surf Camp Retreat by Lucky Sevan Foundation at San Onofre State State Beach located at 830 Cristianitos Road, San Clemente, CA 92672.

The mission of Lucky Sevan (L7) is to use the beach and Mother Ocean and the surfing experience as the backdrop to teach young people how to deal with life’s challenges and see them as opportunities for growth in a loving, supportive, and inclusive environment. The youth are led and taught in daily workshops and team building and discussions about communication, inclusion, trust, self-image and self confidence, and physical, mental, spiritual, and emotional discipline as the essential pillars for strength to unlock their true potential and incorporate these principles into their everyday life.

This retreat operates as a 501(c) – 3 non-profit through the efforts of its founders and generous donors. L7 is not sponsored or endorsed by The Church of Jesus Christ of Latter-day Saints or any of their affiliates; however, the foundation’s principles, vision, and values are aligned with those of the Church. While primarily a member-created board and community, our youth leadership retreat experiences are open to youth of ALL faiths, ages 15-19 who are focused on service and open to instilling and strengthening core values and building their own foundations through a personal relationship with God.

As a retreat and in accordance with our curriculum, each youth will truly unplug. Cell phone, iPod/MP3 player, tablet, and/or any other electronic devices that are brought, save cameras, will not be used or have access to their personal cell phone to respond to calls, texts, emails, or to the internet during the duration of the youth retreat. I, along with all L7 Mentor Leaders will have our cell phones, should an emergency arise. We will also return devices and/or cell phones to youth at the end of the retreat.

By signing the form below you shall hold me or anyone associated with Lucky Sevan Foundation, Inc. harmless and/or any of its L7 Staff and L7 Mentor Leaders and L7 Participants of our Youth Leadership Surf Camp Retreat and give me consent, if absolutely necessary, to act as his/her parent/guardian in a responsible manner should an unforeseen medical emergency arise. Please provide medical insurance information for unforeseen medical attention, if you have it available, in the space provided on the subsequent page. Thank you for entrusting us with your youth. As we have photographers and videographers on staff capturing images and film during the retreat we ask for your permission to post and share images, videos, and participants comments to further our mission of strengthening the youth.

In service,
Evan D. Rogers
Lucky Sevan, Founder/CEO
c: 602.620.3417
e: evan@luckysevan.org

Download Parent Letter

LIABILITY RELEASE

MEDIA RELEASE

COVID-19 RELEASE

LIABILITY RELEASE WAIVER

Organization Name/Named Insured (as shown on policy/certificate): LUCKY SEVAN FOUNDATION, INC

Name of Lucky Sevan Participant(Required)

LUCKY SEVAN PARTICIPANT INSURANCE CARD INFORMATION IF MEDICAL ATTENTION IS NECESSARY:

Name of Insurance Provider(Required)

Group Name(Required)

Group #(Required)

Subscriber #(Required)

Member #(Required)

Emergency Contact Name(Required)

Mobile(Required)

In consideration of being allowed to participate in any way in the program, related events and activities, I the undersigned, acknowledge, appreciate, and agree that:

The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death.

I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation.

I willingly agree to comply with terms and conditions for participation. If I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately.

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS LUCKY SEVAN FOUNDATION, INC., its officers, officials, agents and/or employees, other participants, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (RELEASEES), from any and all claims, demands, losses, and liability arising out of or related to any INJURY, DISABILITY OR DEATH I may suffer, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I the undersigned, am(Required)

A PARTICIPANT 18 YEARS OR OLDER
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT AND FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

A PARENT/GUARDIAN OF A PARTICIPANT OF MINOR AGE (UNDER AGE 18 AT TIME OF REGISTRATION)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liability incidents to my minor child’s involvement or participation in these programs as provided above

First Name(Required)

Last Name(Required)

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Today's date

06/07/2025

MEDIA RELEASE AGREEMENT

I, the undersigned, hereby grant permission to Lucky Sevan Foundation, Inc. hereinafter known as “Media” publications including email, marketing brochures, newsletters, social platforms, general publications, website and/or Affiliates, videos or moving photographs, illustrations, advertising, images, likeness, sound, and statements or comments.
Name of Lucky Sevan Participant(Required)

I hereby waive any right to inspect or approve the finished photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of any images videos, comments made.

I the undersigned, am(Required)

A PARTICIPANT 18 YEARS OR OLDER
I am 18 years of age or older and I am competent to contract in my own name. I have read this release before signing below, and I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.

A PARENT/GUARDIAN OF A PARTICIPANT OF MINOR AGE (UNDER AGE 18 AT TIME OF REGISTRATION)
I am the parent or legal guardian of the below named child. I have read this release before signing below, and I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.
First Name(Required)
Last Name(Required)
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Today's date

06/07/2025

COVID-19 RELEASE AGREEMENT

The World Health Organization has declared the novel Coronavirus (COVID-19) a worldwide pandemic. Due to its capacity to transmit from person-to-person through respiratory droplets, the government has set recommendations, guidelines, and some prohibitions for Lucky Sevan Foundation, Inc. (the "Organization") adheres to compliance.
In consideration of my participation in the foregoing, the undersigned acknowledge and agree to the following:

I am aware of the existence of the risk of my physical appearance to the venue and my participation in the activity of the Organization that may cause injury or illness such as, but not limited to Influenza, MRSA, or COVID-19 that may lead to paralysis or death.

I have not experienced symptoms of fever, fatigue, difficulty in breathing, or dry cough or exhibiting any other symptoms relating to COVID-19 or any communicable disease within the last 14 days.

I have not, nor any member(s) of my household, traveled by sea or by air, internationally within the past 30 days.

I did not, nor any member of my household, visit any area within the United States that was reported to be highly affected by COVID-19, in the last 30 days.

I have not been, nor any member(s) of my household, diagnosed to be infected of COVID-19 virus within the last 30 days.

Following the pronouncements above I hereby declare the following:

I am fully and personally responsible for my own safety and actions while and during my participation and I recognize that I may in any case be at risk of contracting COVID-19.

With full knowledge of the risks involved, I hereby release, waive, discharge the Organization, its board, officers, independent contractors, affiliates, employees, representatives, successors, and assigns from any and all liabilities, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, injury, or death, that may be sustained by me related to COVID-19 while participating in any activity while in, on, or around the premises or while using the facilities that may lead to unintentional exposure or harm due to COVID-19.

I agree to indemnify, defend, and hold harmless the Organization from and against any and all costs, expenses, damages, lawsuits, and/or liabilities or claims arising whether directly or indirectly from or related to any and all claims made by or against any of the released party due to injury, loss, or death from or related to COVID-19.

Name of Lucky Sevan Participant(Required)
I the undersigned, am(Required)

A PARTICIPANT 18 YEARS OR OLDER
I acknowledge that I have read the foregoing Liability Release Waiver and understand its contents; that I am at least eighteen (18) years old and fully competent to give my consent; That I have been sufficiently informed of the risks involved and give my voluntary consent in signing it as my own free act and deed; that I give my voluntary consent in signing this Liability Release Waiver as my own free act and deed with full intention to be bound by the same, and free from any inducement or representation. This waiver will remain effective until laws and mandates relevant to COVID-19 are lifted.

A PARENT/GUARDIAN OF A PARTICIPANT OF MINOR AGE (UNDER AGE 18 AT TIME OF REGISTRATION)
I acknowledge that I have read the foregoing Liability Release Waiver and understand its contents; that I am a minor under the age of eighteen (18) years old and fully competent to give my consent; That I have been sufficiently informed of the risks involved and give my voluntary consent in signing it as my own free act and deed; that I give my voluntary consent in signing this Liability Release Waiver as my own free act and deed with full intention to be bound by the same, and free from any inducement or representation. This waiver will remain effective until laws and mandates relevant to COVID-19 are lifted.
First Name(Required)
Last Name(Required)
Email(Required)

Today's date

06/07/2025

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Location: 2129 E Warner Rd, Suite 101 Tempe, AZ 85284

Telephone: (602) 620-3417

Email: evan@luckysevan.org