Consent & Child Protection Agreements PLEASE READ CAREFULLY - THIS RELEASE AND WAIVER IS A LEGAL DOCUMENT. AGREEMENT FOR MEDIA RELEASE
I grant my permission for Westminster staff or designated adult volunteers to photograph and film me during Westminster activities and trips, understanding that my image may be used in promotional materials or otherwise published in print or digital form. If I wish to revoke this media permission, I will directly email Youth Pastor Olivia (o.patterson@wpc-alex.org) and Program Assistant Jessica Thurnes (j.thurnes@wpc-alex.org) to inform them and make any additional specifications. I Agree AGREEMENT FOR CONTACT IN MINISTRY As an adult volunteer, I agree to keep a record of written communication with any youth (e.g. save emails, cell providers can access texts). I agree to avoid private messaging any youth via my personal social media accounts unless first contacted by Youth (e.g. DMs). I understand that Westminster staff and volunteers may NOT participate in image or video messaging with any youth over social media (e.g. Snapchat). I understand that I am always welcome to include or CC the Youth Pastor to ensure transparency. Should I ever feel unsure or uncomfortable about communication with a youth, I will send a copy or screenshot to the Youth Pastor and discuss with them how to proceed. I Agree AGREEMENT TO REPORT SUSPECTED ABUSE OR INTENT TO HARM The Youth Pastor and church staff who work with minors are all considered mandatory reporters under Virginia state law, meaning we have a legal responsibility to report suspected abuse, neglect, or exploitation of minors and vulnerable adults, including sexual exploitation. As an adult volunteer working with minors, you are required to report this information to the Youth Pastor as quickly and discreetly as possible -- a) if you witness evidence or hear something about abuse, neglect, or exploitation; b) if a minor discloses to you anything about abuse of themselves or others; c) if a youth indicates intent to harm themself or others. If a youth wants to disclose something to you and asks for secrecy, please ask them to trust your discretion and allow them to share if you are comfortable. Once they have shared, or if you are not comfortable with them disclosing, encourage them to come with you to speak with the Youth Pastor; otherwise, make the report yourself. If the Youth Pastor is not available, please report to another Pastor; or to a Program Director if a pastor is not available. I Agree Medical Release & Waiver of Liability AGREEMENT FOR MEDICAL TREATMENT In the event of injury, illness, or medical emergency, if I am unable to make medical decisions and my emergency contact cannot be reached, I hereby authorize the Westminster staff and chaperones to procure any medical attention they consider necessary and expedient for me. I agree to pay for all expenses incurred for medical attention I receive while participating in any Westminster Presbyterian Church-sponsored activity. I understand that it is my responsibility to provide medical coverage for myself and agree to notify Westminster and relevant staff if and when our medical coverage changes. I also understand that Westminster staff reserve the right to restrict me from any activity that they feel is not within their physical, mental, or emotional capabilities at a given time. I Agree AGREEMENT TO WAIVE LIABILITY Westminster Presbyterian Church (hereafter referred to as "Westminster"), 2701 Cameron Mills Road, Alexandria, Virginia, 22302, is a non-profit church organization and a member church of the Presbyterian Church (USA). The undersigned ("Chaperone") desires to participate in programs and activities sponsored by the Westminster Youth Program. For Westminster to permit the participation of the Chaperone in such programs, I hereby agree to the following: 1. I acknowledge that there are potential dangers in participating in all programs sponsored by the Westminster Youth Program, including traveling to and from mission sites and working at mission sites. Thus, I agree that I participate at my own risk and assume full responsibility for personal injury and property damage I may sustain while participating in such programs. 2. I will not hold liable Westminster Session, pastors, directors, employees, youth advisors, chaperones, volunteers, or other agents ("Released Parties"), and I will hold them harmless for any claims, demands, injuries, damages, actions, or cause of actions by others in the course of or resulting from my participation in WPC events and activities. 3. I hereby expressly forever release and discharge Released Parties from all such claims, demands, injuries, damages, actions, or causes of action, and from all acts of passive or active negligence on the part of Released parties. 4. I agree not to sue or make a claim against the released parties for injury, damage, or loss sustained as a result of my participation in the Westminster trips or activities. I agree to indemnify, defend, and hold harmless the Released Parties from all claims, judgments, and costs, including attorney's fees, incurred in connection with any action brought by me or on my behalf. 5. 5. WPC strongly recommends that I consult my health/medical insurance policy to determine whether I have adequate health and medical coverage. For international trips, WPC strongly recommends purchasing short-term international travel insurance. 6. The foregoing agreements shall extend to all programs and activities of the Westminster Youth Program, September 1, 2024 through August 31, 2025. I Agree By signing this waiver, I certify that I have carefully read these agreements & this liability waiver, and hereby agree to their terms.
Date: October 9, 2024
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