Your health is very important to us. We want to be sure that we can serve you well during our program. The information provided will be handled confidentially.
Emergency Contact Information
By checking the below box, I understand and agree that the ASCEND Conference on Jan 3 - 6, 2023 and held at the Wyndham Hotel in Orlando, Florida, hosted by St. Paul’s Outreach, Inc. (herein after referred to as “SPO”) of which I am a participant, involves certain risks due to the COVID-19 pandemic.
While SPO is taking certain precautions, it is possible that some participants including me will be exposed to and possibly catch the virus. This might happen while traveling to or from the event, or while attending the retreat.
Knowing this information, in consideration of my participation in the above event:
Assumption of Risk/Release of Liability
By checking the below box, I hereby agree to release Saint Paul's Outreach (SPO), its representatives, agents, servants and employees from liability for any injury resulting from any cause whatsoever occurring to me at any time while attending the conference in my location, including travel to and from the conference, excepting only such injury or damage resulting from grossly negligent or intentional acts of SPO, its agents, servants and employees.
I voluntarily assume all other risks and danger relating to the conference, whether occurring prior to, during or after the event. I do voluntarily authorize SPO and/or its designees to administer and/or obtain emergency diagnostic procedures or emergency medical treatment for me as deemed necessary in medical judgment. Any further treatment will require my consultation.
Photography and Sound Release
By my attendance at the conference, I hereby grant Saint Paul's Outreach (SPO) permission to make still or motion pictures and sound recordings of the conference and any related events featuring my image and/or words, separately or in combination, and also give a production and/or recording company approved by SPO permission to use the finished silent or sound pictures and/or sound recordings as deemed necessary or helpful.
Further, I so hereby relinquish to SPO all rights, title, interest in and income from the finished sound or silent motion pictures, still pictures, sound recordings, negatives, prints, reproductions and copies of the originals, negatives, recording duplicates and prints that contain my image and/or words, and further grant SPO the right to give, sell, transfer and/or exhibit the same to any individual, business firm, publication, television station, radio station or network, or governmental agency, or to any of their assignees, without payment or other consideration to me.
By clicking Submit, you will be registered for ASCEND 2023!