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Participant Liability Release and Waiver

I understand that my decision to participate in a Life Center’s (LC) activities is entirely voluntary. For and in consideration of my being permitted to participate in LC, I fully accept the responsibility and assume the risk of any injury or damage suffered by me, either directly or indirectly, while participating. I understand that the LC does not assume any responsibility for my safety in connection with LC activities.

I hereby expressly release, discharge, and hold harmless LC, Fountain of Life Center, Life Center Academy and all affiliated organizations, its officers, agents, and employees from any liability and claims resulting from damage and/or injury to my person or property in connection with LC activities.

I further agree to indemnify and hold harmless from all claims, costs, liabilities, expenses or judgments arising out of any loses, damages, illness, deaths, or other casualties suffered by me or any other person, LC, Fountain of Life Center, Life Center Academy and all affiliated organizations in connection with my participation in LC activities.

It is my intention, by this instrument, to exempt LC, Fountain of Life Center, Life Center Academy and all affiliated organizations, and relieve from liability for personal injury, property damage or wrongful death caused by negligence or otherwise, to the full extent of applicable laws. I agree that under no circumstances will I prosecute or present any claim for personal injury, property damage or wrongful death against the LC, Fountain of Life Center, Life Center Academy and all affiliated organizations, arising out of or connected in any way with my participation in or presence at LC activities at any time, whether as a result of LC, Fountain of Life Center, Life Center Academy and all affiliated organizations.

I Agree

Today's date: February 8, 2023



First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Event Group Field
With my signature below, I certify that I (or parent or legal guardian if participant is under 18 years of age) have read and understand this Release and Waiver. I further certify that it is my intention, by signing this Release and Waiver that it is binding upon my heirs, administrators, executors, successors, and assigns. I am signing this Release and Waiver voluntarily and understand that it is legally binding.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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