ABUNDANT LIFE BAPTIST CHURCH
PARENTAL RELEASE WAIVER & INDEMNITY AGREEMENT
(Print Minor’s Legal
Name)_____________________________ (hereafter
referred to as the “minor”) does hereby state that the “minor” wishes to participate in activities sponsored by the Abundant Life Baptist Church in
Washington, Pennsylvania (hereafter referred to as “ALBC”) by attending the Youth Group outing to _________________________________.
It is the desire of “ALBC” to provide a safe and enjoyable experience for the
youth in a setting conducive to developing and strengthening personal
relationships with Jesus Christ our Lord and Savior. It is a fact, however, that participating in youth group
activities carries with it a certain risk of personal injury and/or property
damage. By participating in these
activities the “minor’s” parent
and/or guardian voluntarily accepts and assumes this risk as follows.
For and in consideration of
permitting “minor” to observe, or
use any facility or equipment of “ALBC” or engage in and/or receive
instruction in any activity or activity incidental thereto some of which may
involve dangers and risk of bodily injury while at “ALBC” or in transit to and from “ALBC” and to and from the site of planned activities, the
undersigned parent and/or guardian hereby voluntarily and absolutely releases,
discharges, waives and relinquishes any and all loss or damages or actions or
causes of action for personal injury, property damage, or wrongful death
occurring to “minor” as a result of “minor’s” observing or using facilities
or equipment of “ALBC” and/or being
transported, or engaging in or receiving instruction in any activities some of
which may involve dangers and risk of bodily injury or in activities incidental
thereto wherever or however the same may occur, and for whatever period said
activities or instructions may continue.
It is the intention of the
undersigned parent or legal guardian of “minor”
by this agreement to exempt and relieve “ALBC”
and its officers, agents, servants, or employees from liability for personal
injury, property damage, or wrongful death of minor caused by any act of
negligence of “ALBC” and its
officers, agents, servants, or employees.
The undersigned parent or
guardian of “minor” for him/herself,
his/her heirs, executors, administrators, or assigns agrees that in the event
any claim for personal injury, property damage, or wrongful death shall be
prosecuted against “ALBC” or its
officers, agents, servants, or employees, the undersigned parent or guardian
will indemnify and hold harmless “ALBC”
and/or its officers, agents, servants, or employees from any and all claims or
causes of action by “minor” or by
any other person or entity, by whomever or wherever made or presented, and
under no circumstances will the undersigned parent or guardian of “minor” present any claim against “ALBC” or its officers, agents,
servants or employees for personal injuries, property damage, wrongful death or
otherwise caused by any act of negligence by “ALBC” or its officers, agents, servants or employees.
The undersigned Parent and/or Guardian represents that
he/she has read this release and understands the terms and the legal
consequences of the signing of this release.
The undersigned Parent and/or Legal Guardian intends his or her
signature to be a complete and unconditional release of all liability to the
greatest extent allowed by law and if any portion of the release is held
invalid, it is agreed that the balance shall, not withstanding, continue in
full legal force and effect.
________________________________________ _______________________________
Name of “Minor” (PRINT) Date of Birth
________________________________________ ___________________ ___________
Home Address (Street) City State
_______________________________ ______________________________ ___________
Parent/Legal Guardian Name (PRINT) Parent/Legal Guardian Signature Date