Coastal Activity Release Form

Work Entry

Added: 5/20/2022

COASTAL COMMUNITY CHURCH ACTIVITY RELEASE FORM

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EMERGENCY CONTACTS

INSURANCE INFORMATION

MEDICAL, PICTURE/VIDEO, AND RELEASE OF ALL CLAIMS

Please initial below that you have read and understand the following:

In consideration of Participant’s use of Facilities and participation in Coastal Community Church’s sponsored activities, I, in my legal capacity as parent/guardian of Participant, agree on behalf of myself and Participant that Coastal Community Church, its officers, directors, agents, employees, volunteers, insurers and representatives (“Releasees”) will not be liable for any personal injury, property damage, disability, death, sickness (including transmission of viruses like COVID-19) or disease incurred by Participant, however occurring including, but not limited to, the negligence of Releasees. I understand that Participant and I will be solely responsible for any loss or damage, including personal injury, property damage, disability, death, sickness or disease sustained from the use of Facilities and participation in Programs.

In consideration for the opportunity to participate in the Coastal activity, the participant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the activity. The participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the activity or during transportation to and from the activity, as well as for any medical treatment rendered to the participant that is authorized by the sponsor or its agents, employees, volunteers, or any other Coastal representatives. Further, the participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless Coastal Community Church and its representatives for any injury arising directly or indirectly out of the described activity or transportation to and from the activity, whether such injury arises out of the negligence of the activity sponsor, the participant, or otherwise.

I give permission to publish pictures and/or videos of Participant engaged in sponsored activities.

I, in my legal capacity as parent/guardian of Participant, understand that in the case of injury or sickness, every attempt will be made to contact me, but in case I cannot be reached, I give my consent for Participant to be treated by emergency and medical are professionals, as they deem necessary.

Further, should it be necessary for the participant to return home due to medical reasons, disciplinary action or otherwise, I hereby assume all transportation costs. I have read, understand and received a copy of the Participant's Guidelines.

If a dispute over this agreement or any claim for damages arises, the participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the participant (or parent/guardian) and the activity sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution in accordance with the rules of the American Arbitration Association.

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