Event Information

Your Information

Emergency Contact Information

Insurance Information

Waiver and Release

I acknowledge the personal benefits accruing to me by reason of participation in the above indicated event and am aware of the activities in which I will be involved through said participation.  In consideration of such benefits and other good and valuable consideration received, I consent to the above listed participation and release absolutely, forever discharge, hold harmless and covenant not to sue Grace Life Baptist Church (GLBC) or it’s employees, agents, volunteers, and affiliates (hereafter referred to as “representatives”) from any and all present or future liability, claims, demands, actions, or rights of action, whether asserted by me or a third party arising out of my participation in event activities.  I agree to indemnify GLBC for any such claims brought by me or a third party from any costs associated with defending or litigating such claims, including but not limited to attorney fees, costs and legal expenses.  I am aware of the risks associated with participation in the event and voluntarily assume full responsibility for any risk of loss, property damage or personal injury, including death, that may result from participation in event activities.  In the event of injury or a medical emergency, I understand that a GLBC “representative” will attempt to contact the “emergency contact” indicated above. Should that person not be reached, or should immediate medical services be deemed necessary by a GLBC “representative”, I give permission to that representative to assess medical needs, obtain and consent to appropriate medical care, including transportation to an appropriate medical facility on my behalf. I release GLBC and it’s “representatives” from any and all liability related to medical treatment. In addition, I assume the risk and financial responsibility for any injury resulting from my participation in all event activities.  I represent and acknowledge that I have completely read and understand this document and all its terms, that I have had an ample opportunity to obtain the advice of counsel and that, by signing this document, I understand that I am relinquishing legal rights and remedies that may have otherwise been available to me. I understand that this Waiver and Release shall be construed as broadly and inclusively as is permitted by applicable law and agree that if any portion of this document is held invalid, the remaining shall continue in full force and effect. To the extent the restriction on filing lawsuits is deemed unlawful, I agree to submit any claims to a Christian conciliation/mediation organization for binding resolution.  I know that media may be used to capture comments, interviews, pictures and video of event activities in which I will participate. I give my consent and permission for the taking of photographs, recordings, statements, and/or video of me during and regarding event activities. I grant to GLBC the right to edit, use, and reuse these materials for its purposes in print, on the internet, and all other forms of media and assign any and all rights in such materials. I release GLBC and its “representatives” from all claims, demands, and liabilities whatsoever in connection with the above.