LIABILITY, MEDICAL AND PHOTO RELEASE FORM
Department or Activity: First Love Skate Night (September 2022 - March 2023)
Liability and Medical Release:
We (I) do hereby release, forever discharge and agree to hold harmless Portland Christian Center (Church), the staff and volunteers 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 participant that occur while said participant is participating in the above described trip or activity. Furthermore, we (I), assume all risk of personal injury, sickness, death, damage and expense as a result of participation in transportation, recreation and work activities involved therein. Further, authorization and permission is hereby given to said Church to furnish any necessary transportation, food and lodging for this participant. The undersigned further hereby agree(s) to hold harmless and indemnify said Church, its directors, employees and agents, for any liability sustained by said Church as the result of the negligent, willful or intentional acts of said participant, including expenses incurred attendant thereto.
We (I), hereby grant our (my) permission for my child to participate fully in Portland Christian Center’s trip or activities, and hereby give our (my) permission to take said participant to a doctor or hospital and hereby authorize medical treatment, including but not limited to emergency surgery or medical treatment, and assume the responsibility of all medical bills, if any. Further, should it be necessary for the participant to return home due to medical reasons, family emergencies, disciplinary action or otherwise, we (I) hereby assume all transportation costs.
Today's Date: September 26, 2022