Cce Youth Ministry Liability Release Form

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CCE Youth Ministry Liability Release Form
Release of All Claims/Permission to Treat
In consideration for being accepted by Christ Church Episcopal for participation
in Christ Church Youth Ministry trips, retreats, and activities, including without limitation,
Student Life Camp, mission trips, Youth Group, small group ministry (collectively, “CCE-
sponsored Activities”) we, (I) being 18 years of age or older, for myself and on behalf of
my youth-participant who is under 18 years of age, do hereby release, forever discharge
and agree to hold harmless Christ Church Episcopal and its staff, employees, directors,
and its adult volunteer leaders (collectively, “ CCE and its Agents”) 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 youth participant that occur while said youth is participating in any
CCE-sponsored Activity.
Furthermore, we (I) and on behalf of our (my) youth participant hereby assume
all risk of personal injury, sickness, death, damage and expense as a result of
participation in any CCE-sponsored Activity .
Further, authorization and permission is hereby given to CCE and its Agents to
furnish necessary transportation, food and lodging for this participant.
The undersigned further hereby agrees to hold harmless and indemnify CCE and
its Agents, for (A) any liability or claim CCE or its Agents are subjected to as the result of
my participation or my youth participant’s participation in any CCE-sponsored Activity or
(B) any damages CCE or its Agents sustain as the result of the negligent, willful or
intentional acts of said participant, including expenses incurred attendant thereto.
We (I), are the parent(s) or legal guardian(s) of this participant, and hereby grant
our (my) permission for him/her to participate fully in all CCE-sponsored Activities, and
hereby give our (my) permission to CCE and its Agents to administer over-the-counter
medications to participant and to take participant to a doctor, medical clinic, or hospital
and also do hereby authorize medical examination, treatment and care if deemed
necessary for this participant, including authorization of the release of the medical
information contained on the reverse side hereof to appropriate medical personnel and
heath insurance companies. We (I) assume the responsibility of all medical bills, if any.
We (I) hereby grant to CCE and its Agents the right to take photographs, video
and other media recordings of participant in connection with CCE-sponsored Activities,
and authorize and license CCE and its Agents to use, reproduce and publish these
photographs and recordings, in print or electronically, with or without participant’s name
for any lawful purpose, including without limitation publicity, promotion, advertising and
Web-content.
Further, should it be necessary for the participant to return home due to medical
reasons, disciplinary action or otherwise, we (I) do assume all transportation costs.
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