Northshore Community Church Waiver
CAUTION: Read carefully before signing. In consideration for my participation in the Program(s) of the Church, I represent, warrant and promise as follows:
1) I represent myself and/or I am the parent or legal guardian of the Child identified in this form & I request permission to participate in programs run by, through, or at Northshore Community Church through its employees and agents (together the "Church"). I understand that the Program identified above may include the listed Activities among many others and that all such activities include both known and unknown risks.
2) I grant permission to the Church to take me (or my child if listed) to a licensed medical provider and obtain medical treatment, including without limitation emergency surgery and hospitalization if I appear to require medical attention. I give my consent to any licensed physician to administer drugs or medicine or to perform such medical procedures as that physician determines necessary to preserve my (or my child if listed) life or health or relieve pain. I retain the full responsibility for all medical, transportation, rescue and other related expenses incurred for my well-being in the event I receive medical attention. I agree to provide any information requested by the Church to help resolve any insurance claim.
3) I give permission for the Church to use my (or my child if listed) photographic or video likeness for ministry-related media promotions or productions.
4) I release and agree to hold harmless, defend and indemnify the Church and its directors, officers, employees and agents from and against any and all claims for personal injury (including without limitation loss of life) and all other losses or damages (except those caused entirely by the gross negligence or willful misconduct of the Church) that I (or my child if listed) may suffer as a result of my participation in the Program.
By signing this document, I acknowledge that if I (or my child if listed) am hurt or property is damaged during my participation in the Program, I may be found by the Court to have waived my right to maintain a lawsuit against Northshore Community Church, its employees and agents and may be legally required to defend and indemnify the Church against claims brought by others on my behalf. I have carefully read, understand, and accept all conditions above.