RELEASE, HOLD HARMLESS AND INDEMNITY
I, the undersigned, acknowledge that participating in this sponsored trip involves certain risks and that injury, death or other harm (including damage to property) could occur to me (“Injuries”). By participating in the mission trip, I hereby assume full responsibility for the risk of Injuries, whether caused by negligence or otherwise. I, on my own behalf and on behalf of my heirs, successors, assigns, executors and administrators, hereby RELEASE AND HOLD HARMLESSAND AGREE TO INDEMNIFY Jesus Christ Compass Ministries Inc., its partners, and its staff, volunteer leaders, members, employees, council member, ministry and Church Leadership from and against any and all liability, claims, damages, causes of action, loss, costs and expenses (including, without limitation, attorney fees) for Injuries arising out of or connected with the mission trip, including traveling to and from the location(s) of the mission trip.
MEDICAL AUTHORIZATION
I, the undersigned applicant (or parent/legal guardian if under 18), hereby give permission to Jesus Christ Compass Ministries, its staff, leaders, volunteers, or any designated representatives, to seek and authorize emergency medical treatment on my behalf (or on behalf of my child) in the event of an illness, injury, or medical emergency that occurs during participation in any ministry-sponsored activity, event, or trip.
In these circumstances, I hereby request and authorize any duly licenses physicians, dentists and staff, or other licensed technicians or nurses, to perform any diagnostic procedures, treatment procedures, operative procedures and x-ray treatment as may be necessary, including but not limited to medical transport, hospital tests, injections, anesthesia, surgery and administration of prescription drugs.
I understand that every effort will be made to contact the emergency contact listed on this application prior to any medical treatment. However, if I (or my child) am/is in need of urgent care and I/we cannot be reached, I authorize the attending medical personnel and the ministry representatives to secure and administer such treatment, including hospitalization, anesthesia, surgery, medication, or other procedures deemed necessary by qualified medical professionals.
I agree to the release of any records necessary for treatment, referral, billing, or insurance purposes from any medical contacts provided by. I agree to assume full financial responsibility for any and all medical services rendered, and I release Jesus Christ Compass Ministries, its leaders, staff, and volunteers from any liability in connection with any such medical treatment.