EVENT PARTICIPATION WAIVER AND GENERAL RELEASE OF LIABILITY AGREEMENT

Name of Event: 2023 HF Mission Trip to Guatemala

Date(s) of Event: July 22 - 29, 2023

Location: Quiche, Guatemala

 

IF THE PARTICIPANT IS A MINOR, THIS FORM SHOULD BE COMPLETED AND SIGNED BY PARTICIPANT'S PARENT/LEGUAL GUARDIAN.

 

I Hereby Assume All Of The Risks Of Participating In Any/All Activities Associated With This Event as offered by First Assembly of God of Humble, TX (hereinafter also referred to as “Church”, or “Humble First”), including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or persons or property owned, maintained, or controlled by them, or because of any alleged, perceived, or possible liability without fault.

 

I certify that I, or the minor Participant I am granting permission for, and in accordance with the information I provided in the Forms attached hereto, am physically fit enough, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or other problems which preclude my participation in this activity.

 

I acknowledge that this Event Participation Waiver and General Release of Liability Agreement (hereinafter the  “Agreement”)) and the accompanying Subsections and Forms attached hereto (the “Forms”)will be used by Humble First as the event holders, sponsors, and organizers of the activity in which I, or minors of which I am the parent or legal guardian (hereinafter, and collectively, the “Participant” or “I”), may participate, and that it will govern my actions and responsibilities in choosing to participate in said activity.

I.  INDEMNITY AGREEMENT AND RELEASE OF LIABILITY
In consideration for the Participant to participate in activities of Humble First, while on the premises and property of Humble First or any premises under the supervision of Humble First or in route to or from the said premises or place where activities are sponsored by or participated in by Humble First, the undersigned, for themselves, and/or being the parent or legal guardian of Participant INDEMNIFY, DEFEND, RELEASE AND HOLD HARMLESS HUMBLE FIRST, ITS OWNERS, EMPLOYEES, AND AGENTS, HEREINAFTER, INDEMNIFIED PARTIES, OF AND FROM ANY AND ALL LIABILITY, CLAIMS, DEMANDS, AND CAUSES OF ACTIONS WHATSOEVER, ARISING OUT OF OR RELATED TO ANY LOSS, DAMAGE, OR INJURY, INCLUDING DEATH, THAT MAY BE SUSTAINED BY THE PARTICIPANT AND/OR UNDERSIGNED, WHILE IN,  AT, OR UPON OR EN ROUTE TO OR FROM, THE PREMISES WHERE HUMBLE FIRST CONDUCTS SUCH ACTIVITIES. I AGREE, ON BEHALF OF MYSELF AND/OR BEING THE PARENT AND/OR LEGAL GUARDIAN OF PARTICIPANT TO ASSUME ALL THE RISKS AND RESPONSIBILITIES SURROUNDING MY PARTICIPATION IN THE ACTIVITIES WHILE ON THE PREMISES AND PROPERTY OF HUMBLE FIRST OR ANY PREMISES UNDER THE SUPERVISION, OF HUBLE FIRST, BOTH KNOWN AND UNKNOWN, TO THE MAXIMUM EXTENT ALLOWED BY LAW.

a) I  further Waive, Release, And Discharge from any and all liability, including but not limited to, liability arising from the negligence or fault of Humble First or persons hereby released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, The Following Entities Or Persons: Humble First  and/or their directors, officers, employees, contractors, hired transportation services, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers;

b)  I also Indemnify, Hold Harmless, And Promise Not To Sue Humble First or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of Humble First and/or their directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers hereby released, or otherwise.

I acknowledge that Humble First and their employees, directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf.

I acknowledge that participation in this activity may test or exceed the limits a person's, including but not limited to my, physical and mental limits and carries with it the potential for death, serious injury, and property loss. I understand that the risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other people including, but not limited to, participants, volunteers, monitors, and/or producers of the activity. These risks are not only inherent to participants but are also present for volunteers.

Pursuant to Form 2 attached hereto and agreed by Participant, I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity. I understand that my refusal to willingly accept recommended medical treatment at any time during my participation in the activity shall in no way cause or make Humble First and/or their directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers liable in any way.

Pursuant to Form 6, attached hereto and agreed by Participant, I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns.

II. HUMBLE FIRST EVENT RULES

Each Participant is expected to conform to the following rules of conduct. Participants who fail to comply with these expectations may be required to leave the event immediately at Participant's own expense, or if the Participant is a minor, at the Participant's parent/legal guardian's expense.

•    No possession or use of alcohol, drugs or tobacco

•    No fighting, weapons, fireworks, lighters, etc.

•    No cell phones, gaming devices or other electronic devices that could serve to isolate Participants from others

•    Participation in group is expected

•    Respect property, one another, staff and adult leaders

•    No offensive or immodest clothing, speech or actions

•   No minors in adult sleeping quarters or adults in minor sleeping quarters. Boys and girls are not to be in each other’s quarters (exception: married couples in quarters designated for married couples)

•    Only Church approved adults may drive on behalf of the church and any such Church transportation is subject to the Terms of Form 5 below.

Participant has read the event rules and agrees that Participant will abide by the event rules and any personal/health limitations. If  Participant is a minor, then I, minor Participant's parent or legal guardian, give my permission for the minor Participant to participate in the event pursuant to my agreement and execution of Form 1 attached hereto.

Participant understands that the Event Participation Waiver and General Release of Liability Agreement shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

FORM 1 - Participant Information and Parent or Legal Guardian Permission on behalf of a Minor Participant 

 

EMERGENCY CONTACT INFORMATION

If participant is a minor, the parent or legal guardian signatory will be designated as the primate emergency contact.

FORM 2—Participant Health, Medical, and General Medication Information and Authorization

Personal / Health Limitations:

I AGREE THAT I HAVE INFORMED HUMBLE FIRST OF ANY AND ALL MEDICAL OR HEALTH LIMITATIONS I, OR THE MINOR PARTICIPANT MAY HAVE, INCLUDING ANY AND ALL ALLERGIES AND RELATED MEDICATIONS AND MEDICAL NEEDS, AND I UNDERSTAND THAT ANY AND ALL MEDICATION BEING BROUGHT BY PARTICIPANT, INCLUDING NON-PRESCRIPTION DRUGS, MUST BE TURNED INTO  HUMBLE FIRST PERSONNEL UPON CHECK-IN OF ACTIVITY IN THE ORIGINAL CONTAINER.  I UNDERSTAND AND AGREE THAT I AM AUTHORIZING HUMBLE FIRST, PURSUANT TO FORMS 3 AND 4 HEREIN, TO ADMINSITER MEDICATION AND PROVIDE MEDICAL TREATMENT TO MYSELF AS PARTICIPANT OR THE MINOR PARTICIPANT AS IS NECESSARY.

Over the Counter Medications

I agree that the Participant may be given over-the-counter, non-prescription medications or applications, not to exceed recommended dosage for head or body aches, stomach discomfort, burns, cuts, insect bites, rashes or scrapes with consideration for any exceptions listed below (if none, enter "N/A"):

Participant Health Insurance Information

FORM 3—Medical Treatment Authorization
 

I (the Participant and/or in the case the Participant is a minor, the parent/legal guardian) hereby authorize any Humble First personnel or any person designated by the Church personnel to obtain medical care if necessary and authorize emergency treatment in the event of illness/injury for the Participant. I understand, if necessary, the participant will be taken to a nearby hospital and will be attended by a physician on call. I further understand that I will be responsible for any medical expenses incurred on behalf of the Participant. I also hereby authorize this document to be released to first responders and emergency personnel. I understand that any Participant with a fever, rash, pink eye, head lice other signs of illness will be sent home. I further understand that the Participant, or if the Participant is a minor, the parents/legal guardians, are responsible for their transportation in the event of an illness or injury.

FORM 4—Medication Administration Authorization

In consideration that I (the Participant and/or in the case the Participant is a minor, the parent/legal guardian) may participate in Church events, whether on or off the premises of Church, I authorize any Church personnel or any person designated by church personnel to administer the medications listed on Form 2, "Participant Health, Medical, and General Medication Information and Authorization."

The Participant may be given over-the-counter, non-prescription medications or applications, not to exceed recommended dosage for head or body aches, stomach discomfort, burns, cuts, insect bites, rashes or scrapes with consideration for any exceptions listed on Form 2.

FORM 5—Transportation Authorization and Release

Pursuant to this entire Agreement, if Humble First is providing transportation to and from this event, I give Humble First permission to transport the Participant, including myself and/or any minor children I am giving permission for, to and from the event for the purpose of the event. I FURTHER AGREE TO THE SAME INDEMNITY AND RELEASE AS DESCRIBED IN THE ABOVE PARAGRAPH I a)  OF THIS AGREEMENT TO THE INDEMNIFIED PARTIES ARISING FROM SUCH TRANSPORTATION TO OR FROM THIS EVENT, INCLUDING BUT NOT LIMITED TO BY DRIVERS, CONTRACTED DRIVERS AND TRANSPORTATION COMPANIES, and EMPLOYEE-DRIVERS.

Pursuant to this entire Agreement, if the Church is not providing transportation to and from this event, or if I, as the Participant, or as the minor Participant’s parent/legal guardian, have/has chosen to provide Participant’s own transportation. I AGREE TO PROVIDE THE SAME INDEMNITY AGREEMENT AS DESCRIBED ABOVE IN PARAGRAPH 1 OF THIS AGREEMENT.

FORM 6—Model and Use of Name, Image, Likeness Authorization and Release

In consideration of Participant being allowed to participate in Church events, whether on or off the premises of the Church, I hereby authorize Humble First to use Participant's likeness in photographs or video in any and all of its publications and in any and all other media. I agree make and that pursuant to the Waiver and Release I do not have any monetary or other claim against Humble First for the use of such photographs or video.

III. GOVERNING LAW; SUBMISSION TO JURISDICTION.

All matters arising out of or relating to this Agreement shall be governed by and construed in accordance with the internal laws of the State of Texas, County of Harris, without giving effect to any choice or conflict of law provision or rule (whether of the State of Texas or any other jurisdiction).

 

IV. PARTICIPANT CERTIFCATION AND ACCEPTANCE.

I Certify by entering my email, that I, on behalf of myself as Participant or the minor I am granting permission for participation in the event, that I have read this Waiver and Release Agreement and its accompanying Forms in its entirety and I Fully Understand Its Content. I Am Aware That This Is A Release of Liability And A Contract And I Sign It Of My Own Free Will.

 

V.  EVENT PERMISSION and E-SIGNATURE:

E-sign Act and EUTA Disclosures: By entering my email, I further verify that I have carefully read this Agreement and the accompanying Forms in its entirety and consent to signing this document electronically. I understand that if I wish to submit a physical copy, I may request one from the office of First Assembly of God of Humble, Texas.