CENTENARY ACTIVITIES PARTICIPATION & PHOTO USE AGREEMENT

CENTENARY ACTIVITIES PARTICIPATION & PHOTO USE AGREEMENT

Activities information: Centenary All-Church Ministry Activities, Children's Ministry Activities, and/or Student Ministry Activities

Activity Sponsor: Centenary United Methodist Church - 1911 Toyon Ave. Modesto, CA 95350

Name of sponsor's coordinator: Centenary Ministry Staff, Children's Ministry Team, and/or Student Ministry Team - (209) 527-5441 - centenary@centenarychurch.net

Release for Activity Dates: June 1, 2025 through May 31, 2026

PARTICIPANT INFORMATION (TO BE COMPLETED BY AUTHORIZED GUARDIAN)

Name of participant

Date of Birth

Date

Current Grade

Name of parent/guardian

Address

Phone

Format: (000) 000-0000.

Parent/guardian email

example@example.com

Name of emergency contact

Emergency contact phone

Format: (000) 000-0000.

Emergency contact's relationship to participant

List allergies or medical conditions/concerns

Is the sponsor authorized to approve medical treatment?

Is the participant covered by personal/family medical insurance?

If yes, name of insurer

Policy or group number

PARTICIPATION AGREEMENT

I acknowledge that participation in the activity described above involves risk to the participant (and to the participant's parents or guardians, if the participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, exposure to infectious/communicable disease, bodily injury, death, emotional injury, personal injury, property damage, and financial damage. In consideration for the opportunity to participate in the activity described above (the "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 representatives (collectively referred to as the "activity sponsor"). Further, the participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the activity sponsor 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.

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.

Parent/Legal Guardian's Signature

Date

Parent/Legal Guardian's Name (please type)

IMAGE/AUDIO PERMISSION RELEASE FORM

FOR CENTENARY UNITED METHODIST CHURCH, MODESTO MINISTRY ACTIVITIES

Release for Activity Dates: June 1, 2025 through May 31, 2026

I, Parent/Legal Guardian's Name , understand and acknowledge the Centenary Ministry staff/volunteers (hereinafter, "Ministry"), may take recordings (including but not limited to photographs, video, audio, digital or otherwise, etc.) during Ministry events and activities which may include my child,Child's Name (hereinafter, “Child”).

Please check one box below to indicate your consent:

I, Parent/Legal Guardian's Name , understand and acknowledge the Ministry may take recordings (including but not limited to photographs, video, audio, digital or otherwise, etc) during events and activities which may include my Child, Child's Name , (individually or in the company of others), and have no objection to such. The Ministry may use these recordings for promotional purposes, including but not limited to online and print advertising materials, newsletters, etc. No monetary compensation will be made for usage of the recordings. It is understood that any such recordings will be done only with the permission of and under the supervision of Ministry staff and/or administration.

I, Parent/Legal Guardian's Name understand and acknowledge the Ministry may take recordings (including but not limited to photographs, video, audio, digital or otherwise, etc.) during events and activities which may include my Child, Child's Name , (individually or in the company of others). The Ministry may not use these recordings for any purpose.

If any child does not have permission to be recorded, the Ministry to the best of its ability and will not, intentionally post recordings to any Ministry publication.

By signing this, I acknowledge that I am the legal guardian of Child's Name* .

By signing below, I acknowledge that I have read, understood, and agree to the terms contained in this Image/Audio Permission Release Form

Parent/Legal Guardian's Signature

Date

Parent/Legal Guardian's Name (please type)