• Level 1 Youth Leadership Initiative Registration

    **If your son is 18 years old, please ensure your son completes the form with you or is available to sign the final pages of registration**
  • Youth Information

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  • Medical Information

    Please let us know of any medical conditions, serious illness or health concerns. Please answer accurately to help our Program Director and Lead Medic understand any specific areas of concern. This information is confidential.
  • IMMUNIZATIONS: The 4MUS team recommends an up-to-date tetanus shot and that all other required immunizations are up to date.

  • Release and Waiver of Liability

    This Waiver, Release of Liability, Indemnification, and Consent to Medical Attention must be completed before participation.  Please read the entire document carefully as it does contain waiver, release of liability, indemnification, and other important provisions.
  • 1) Voluntary Participation. I understand and confirm that my participation in the Youth Leadership Initiative (“Activity”) is voluntary.
     
    2) Identification of Risks. I understand that my participation in the Activity may involve a risk of injury, illness, and loss, both to person and to property. I also understand that the risk of injury or illness may include the possibility of permanent disability and death. I understand that this Waiver, Release of Liability, Indemnification, and Consent to Medical Attention (“Waiver”) is intended to address all of the risks of any kind, whether known, unknown, anticipated, unanticipated, or otherwise, associated with my participation in any aspect of the Activity, or with the time I am involved in the Activity, including, but not necessarily limited to, such risks caused by the acts, omissions, inaction, carelessness and/or negligence on the part of ALL4ONE Inc. dba 4M, and/or any of their officers, pastors, employees, representatives, agents, volunteers, successors or assigns (collectively ALL4ONE Inc. dba 4M "Representatives"), including, but not necessarily limited to, risks created by the following:

    (a) The use and condition of various modes of transportation, premises, facilities, and equipment utilized in the Activity;

    (b) The lack or inadequacy of policies, rules, or regulations for the Activity;

    (c) The failure of ALL4ONE Inc. dba 4M or its Representatives to foresee or to protect me from actions, inactions, or negligence of any person, or the recklessness, intentional, or criminal misconduct of persons not affiliated with ALL4ONE Inc. dba 4M;

    (d) The inadequacy or unavailability of medical facilities or treatment during the Activity; or

    (e) The lack or inadequacy of supervision by ALL4ONE Inc. dba 4M or its Representatives.

    3) Assumption of Risk. I assume all risks, known and unknown, foreseeable and unforeseeable, whether or not specifically identified in this Waiver, that are in any way related to my participation or involvement in the Activity. I accept personal responsibility for any liability, injury, illness, loss, or damage arising out of my participation in the Activity.

     

    4) Release and Waiver. I hereby release and forever discharge ALL4ONE Inc. dba 4M and its Representatives from any and all liability or responsibility for any injury to person and property, illness, loss, damage, or expense, including attorney’s fees, that I may suffer or incur arising out of or in any manner related to my participation or involvement in the Activity; whether or not caused, in whole or in part, by the acts, omissions, inaction, carelessness or negligence of ALL4ONE Inc. dba 4M or its Representatives. I further waive any and all claims I might have now or may in the future develop for injury to person or property, illness, loss, damage, or expense, including attorneys' fees, arising out of or in any manner related to my participation or involvement in the Activity, whether or not caused, in whole or in part, by the acts, omissions, inaction, carelessness or negligence of ALL4ONE Inc. dba 4M or its Representatives (“Claim” or “Claims”).

    5) Indemnification. I agree to indemnify and hold harmless ALL4ONE Inc. dba 4M and its Representatives from any Claim or any expense, including attorneys' fees, in any manner connected with any Claim I might make, or that might be made on my behalf, that is released or waived by the terms hereof.

    6) Binding Effect. This instrument shall be binding upon my relatives, personal representatives, heirs, beneficiaries, next of kin and assigns and shall inure to the benefit of ALL4ONE Inc. dba 4M and its Representatives.

    7) Severability. If any provision (or portion of any provision) of this Waiver is held to be invalid or unenforceable, that provision shall be enforceable in part to the fullest extent permitted by law, and such invalidity or unenforceability shall not otherwise affect any other provision of this instrument.

    8) Applicable Law. Because ALL4ONE Inc. dba 4M is located in the State of Indiana, and in order to provide certainty in the law to be applied in the construction of this instrument, this instrument shall be governed, construed, and enforced in accordance with the laws of the State of Indiana.

    9) Marketing Release.ALL4ONE Inc. dba 4M may record on videotape, audiotape, or photograph, any participant at any time during the Activity, and may use the applicant’s name, voice, or testimonial without restriction for the future promotional purpose of ALL4ONE Inc. dba 4M unless stated otherwise in writing.

    10) Consent to Medical Treatment. I authorize ALL4ONE Inc. dba 4M and its Representatives, if present, to provide to me, through medical personnel of their choice, customary medical assistance, transportation, and emergency medical services should I require such assistance, transportation, or services as a result of injury, illness or harm related to my participation in the Activity. This consent is given in advance of any specific diagnosis, treatment, surgery, or medications, and is given to provide authorization and specific consent for medical/dental treatment and care on my behalf. This consent does not impose a duty upon ALL4ONE Inc. dba 4M or its Representatives to provide such assistance, transportation, or services.

    11) I certify that I have personal health insurance that provides coverage for medical services rendered to me, which insurance will provide coverage for me during the duration of the Activity. This coverage will insure me FULLY during the duration of the Activity. If I am traveling internationally, my health insurance includes FULL coverage in the foreign countries where I will travel, with no territorial limitations. I understand ALL4ONE Inc. dba 4M provides no health plan and that all medical expenses incurred on my behalf are solely my responsibility.

  • IF MY SON WILL BE UNDER 18 YEARS OF AGE AT THE TIME OF THE EVENT:

    I have thoroughly reviewed this waiver, release of liability, indemnification, and consent. I recognize that by signing it, I am relinquishing significant rights. I am voluntarily signing this document on behalf of my minor son, {firstNamenbsp}.

     

    IF MY SON WILL BE 18 YEARS OF AGE AT THE TIME OF THE EVENT I UNDERSTAND HE NEEDS TO COMPLETE THE FORM WITH ME AND SIGN THE WAIVER HIMSELF.

    I WILL BE 18 YEARS OF AGE AT THE TIME OF THE EVENT AND COMPLETED THIS FORM ON BEHALF OF MYSELF:

    I have thoroughly reviewed this waiver, release of liability, indemnification, and consent. I am aware that by signing it, I am forfeiting significant rights. I am voluntarily signing this document on behalf of myself, {firstNamenbsp}.

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  • 4MUS REGISTRATION, PAYMENT & CANCELLATION POLICY

    IN AN EFFORT TO BE GOOD STEWARDS OF THE BUDGET AND EXPENSES OF 4MUS, THE FOLLOWING POLICIES ARE IN PLACE FOR ANYONE REQUESTING TO CANCEL THEIR 4MUS EVENT REGISTRATION.
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