Grace Students Liability & Medical Release Form

GFC Waiver and Release

We (I) agree to hold harmless Grace Fellowship Church and the directors thereof from any and all liability, claims, or demands for personal injury, sickness, or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the child participant that occur while said child is participating in this event. Furthermore, we (I) [and on behalf of our (my) child participant] hereby assume all risk of personal injury, sickness, death, damage, and expense as a result of participation in recreation and work activities involved wherein. We are (I am) the parent(s) or legal guardian(s) of this participant, and hereby grant our (my) permission for him/her to participate fully in this event, and hereby give permission to take said participant to a doctor or hospital and hereby authorize medical treatment, including but not in limitation to emergency surgery or medical treatment, and assume the responsibility of all medical bills, if any. GUIDELINES AND DISCIPLINARY ACTION: Furthermore, we (I) and said participant fully understand and agree to comply with the following guidelines and support the mentioned appropriate disciplinary action: 1. Physical restraint against another’s will, including verbal threats to bring harm, constitutes assault/battery and will result in dismissal of event and possible lawful action. 2. Possession and/or use of alcohol, tobacco, weapons, or illegal drugs will result in confiscation, dismissal of event, and possible lawful action. 3. Inappropriate sexual conduct will result in immediate consultation, parental awareness, and possible dismissal of event. Should it be necessary for the participant to return home due to disciplinary action, medical reasons, or otherwise, we (I) assume all transportation costs. Photograph and Video Release: I hereby grant to Grace Fellowship Church the rights to use my name, image, and likeness, sound of my voice or performance as recorded photographically, on audio, video tape or other recordable media now known or later developed, without payment or any other consideration. Applies to but not limited to printed material, internal and external use, website, fundraising and social media. These may be electronically displayed via the internet or in a public setting.


If yes, they must be within the same household



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