Immanuel Christian Reformed Church
Waiver and Release Form

THIS IS A LEGAL DOCUMENT. By signing this agreement, you indicate that you have understood the risks associated with the activity, give up certain rights including the right to sue, agree to assume financial responsibility for any injury or damage resulting from the activity, and indicate that you have understood and agree to this agreement. PLEASE READ CAREFULLY.

Activity: 
Location:
Date:

Waiver and Release

In connection with the participant’s (the "Participant") participation in the above-mentioned activity (the "Activity") held by Immanuel Christian Reformed Church ("ICRC"), and any transportation (the "Transportation") that may be associated with the Activity, I, the undersigned, agree to the following terms and conditions:

1. I have full knowledge of the nature and extent of the risks inherent in the Activity and the Transportation, including but not limited to the risk of serious bodily injury or death, property damage or other loss. These risks may be caused by such reasons including but not limited to my own actions or inactions or the actions or inactions of other participants. I nevertheless freely and voluntarily consent to and give permission for the Participant to participate in the Activity and the Transportation, and agree to accept these risks and fully understand that I will be solely responsible for any loss, injury or damage sustained by the Participant.

2. I agree to waive any and all claims that I may have now or in the future against ICRC, its directors, officers, agents, employees and anyone acting on its behalf in connection with the Activity and the Transportation.

3. I agree to release ICRC, its directors, officers, agents, employees and anyone acting on its behalf from and against any and all liability for any loss, injury or damage that the Participant may suffer arising from any cause whatsoever, including the negligence of ICRC or its directors, officers, agents, employees or anyone acting on its behalf, as a result of the Activity and the Transportation.

4. I agree to indemnify and hold harmless ICRC, its directors, officers, agents, employees, or anyone acting on its behalf from any and all claims, demands, expenses, costs (including legal costs), debts or liabilities for which they may become liable as a result of any loss, injury or damage arising out of or in any way associated with the Activity and the Transportation.

5. I authorize ICRC to transport and obtain, through a physician of its own choice, any emergency medical care that may become reasonably necessary for the person in the course of the Activity and the Transportation and I agree to accept the cost of the transportation or treatment by medical personnel or the medical facility.

6. The invalidity or unenforceability of any of the provisions of this agreement will not affect the validity or enforceability of the remainder of this agreement.

I acknowledge that I have read and fully understand this agreement and sign it voluntarily.