Cross Road Christian Church / Waiver & Release Agreement for 2008

RELEASE AND WAIVER OF LIABILITY AND INDEMNITY

In consideration of participation in an event and/or activity promoted by Cross Road Christian Church, the undersigned (for himself, his personal representatives, heirs and next of kin) HEREBY RELEASES Cross Road Christian Church, and their respective officers, pastors, employees, leaders, volunteers, and agents (“releasees”) of all liability to the undersigned, whether caused by the negligent act or omission of releasees or otherwise while the undersigned is for any purpose participating in such event or property use.  It is fully understood by each of the undersigned that there is some inherent risk associated with any event or property usage.  IN ADDITION, the undersigned AGREES TO INDEMNIFY AND HOLD HARMLESS the releasees from any loss, liability, damage, or cost they incur due to such participation by the undersigned, and any guests (including minors) whether caused by releasees’ negligence or otherwise, and AGREES TO ASSUME FULL RESPONSIBILITY AND RISK for any bodily injury, death, or property damage from releasees’ negligence or otherwise while the undersigned is participating at this event or property use.

MEDICAL RELEASE:

I hereby authorize the treatment for myself or the named minor by a qualified and licensed medical doctor in the event of a medical emergency, which in the opinion of the attending physician, may endanger his/her life, cause disfigurement, physical impairment, or undue discomfort if delayed, while participating in a church program including transportation to and from that program. This authority is granted only after a reasonable attempt has been made to contact the emergency contact person below.

INSURANCE RELEASE

I understand that in the event that health coverage is needed, Cross Road Christian Church’s insurance coverage provides benefits only after a participant’s health and accident policy has been extended to its maximum limit.

TRANSPORTATION RELEASE:

I also give my permission for myself or my child to be transported in a church, rental or private vehicle or common carrier.

PERSONAL BELONGINGS RELEASE

I understand that Cross Road Christian Church is not responsible for personal belongings.

PHOTOGRAPH RELEASE

I give permission for Cross Road Christian Church or its partner ministries to use photographs containing my image for informational and/or promotional purposes.

In signing this release, each of the undersigned hereby acknowledges and represents the following:

1. That he/she (or guardian/personal representative) has read the foregoing Release and Waiver of Liability and Indemnity Agreement; and understands that (s)he is assuming liability and indemnifying as to any minor’s damage or injury.

2. That (s)he is free to choose to NOT to participate in the event or free not to use the property or facility.

3. Cross Road Christian Church and their respective officers, pastors, employees, leaders, volunteers, and agents (“releasees”) will not be financially responsible for injury, damages or incurred expenses from such.

4. This agreement is for events and/or activities promoted by Cross Road Christian Church.

5. This release is binding upon my heirs, executors and assigns.

Participant Name (please print) : __________________________ Phone # _______________

Participant Signature : _______________________________________ Date: ____________

In case of Emergency, Contact : ______________________________ Phone # ____________

For Minor Participant(s)

_________________________________, parent or legal guardian of ____________________

(Participants’ parent/legal guardian – please print) (Participant(s) –please print)

____________________________________________________________________________________

(Participant(s) –please print)

Signed: __________________________________________________Date_____________________

(Participants’ parent/guardian if under 18)