Synod Waiver and Release of Liability

Arkansas-Oklahoma Synod Waiver and Release of Liability

For Calendar Year 2026
Whereas, the undersigned Participant wishes to be accepted for participation in events, activities, special programs or transportation to be organized and conducted by the staff and volunteers of the Arkansas-Oklahoma Synod; and, in consideration of the ArkansasOklahoma Synod’s action in allowing the Participant to participate in such a program:

The Participant and the undersigned Parent(s)/Guardian(s) of the Participant acknowledge the Arkansas-Oklahoma Synod Lutheran Youth Organization (LYO) program will necessarily subject the Participant to certain stresses and hazards, not all of which can be foreseen. REASONABLE PRECAUTIONS WILL BE TAKEN TO PROTECT THE PARTICIPANT. IT IS UNDERSTOOD THAT UNFORESEEN CIRCUMSTANCES MAY OCCUR IN SPECIAL PROGRAMS FOR WHICH THE STAFF/VOLUNTEER OR THE ARKANSAS-OKLAHOMA SYNOD CANNOT BE HELD RESPONSIBLE.

The Participant and Parent(s)/Guardian(s) assume all of the ordinary risks normally incidental to the nature of the program, including risks which are not specifically foreseeable.

The Participant and Parent(s)/Guardian(s), for themselves and their respective heirs, personal representatives and assigns, hereby release the Arkansas-Oklahoma Synod, its staff, employees and agents from all liability of any nature for loss or damage to personal property.

The Participant and Parent(s)/Guardian(s), for themselves and their respective heirs, personal representatives and assigns, further release the Arkansas-Oklahoma Synod, its staff, employees and agents from all liability for personal injury resulting from the failure of the Participant or other participants in the special program to obey safety regulations and directions of the leader, or resulting from the exercise of judgment of the staff/volunteer in good faith in response to emergencies and exigencies which occur in the program, provided however, that nothing contained herein shall excuse any member of the staff, employees or agents, or person assigned to be a program leader by a member of the staff, from the responsibility to act with reasonable care for the safety of the undersigned Participant during the course of the program appropriate to the circumstances.

It is the intention of the Participant and Parent(s)/Guardian(s) of the Participant that this agreement will be governed by the laws of the state of Oklahoma.

This waiver and release of liability will be in effect from January 1, 2026 to December 31, 2026.
WE, THE UNDERSIGNED, HAVE READ, AND AGREE TO THE TERMS OF THE FOREGOING RELEASE AND WAIVER OF LIABILITY.
Name

First NameLast Name
Church
Signature of Participant
Date

MonthDayYear
Date
If participant is under 18:
I hereby certify that I am the parent or guardian of First Name* Last Name* , named above, and do hereby give my consent without reservation to the foregoing on behalf of this individual.
Parent Name

First NameLast Name
Signature of Parent
Date

MonthDayYear
Date
Photo and Video Release:
I, being the parent/guardian of First Name* Last Name* , hereby consent that his/her name images and likeness, as shown in the video tapes, photographs, television, and/or electronic images for which she posed, and/or audio recordings made of her voice and/or written or verbal quotes/comments may be used and will become property of the ArkansasOklahoma Synod.
Signature of Parent
Date

MonthDayYear
Date
Should be Empty:

Arkansas-Oklahoma Synod Waiver and Release of Liability

WE, THE UNDERSIGNED, HAVE READ, AND AGREE TO THE TERMS OF THE FOREGOING RELEASE AND WAIVER OF LIABILITY.

Photo and Video Release: