Home. Work. Other Number. Participant Name. Participant Signature. Date. Parent Name. Parent Signature. Date. Notary Sig
IMPACT FAMILY CHURCH, INC. Release Form Winter Retreat 2017
I give permission for my child (if 18 or older, myself), ________________________________, to attend Winter Retreat 2017 with R.A.G.E., the youth ministry of Impact Family Church, Inc., Wednesday, February 1, 2017 through Sunday, February 5, 2017. My child (I) may participate in all activities associated with this outing. I understand that my child (I) has (have) a plentitude of duties, including, but not limited to, skiing / snowboarding / ski/boarding within their (my) abilities, maintaining control, heeding warnings, using lifts safely, and/or not contributing to the injury or harm of another person, and/or their property. I understand that Impact Family Church, Inc., nor its employees, agents, officers, trustees nor volunteers can guarantee that my child (I) will fulfill their (my) duties as specified above and hereby release them from any and all claims arising from my child’s (my) failure to fulfill said duties. I understand that the sports of skiing / snowboarding, ski/boarding and all other related activities involve inherent and other risks of INJURY and DEATH, even if all said duties are fulfilled. I voluntarily agree to expressly assume all risks of harm to property, injury and/or death and/or the injury and/or harm of another person, and/or their property that may result from skiing / snowboarding / ski/boarding and all other related activities, regardless of negligence on my child’s (my) part or that of another. I agree to release Impact Family Church, Inc. (including RAGE Youth Ministry), its employees, affiliates, agents, officers, trustees and/or volunteers from all liability for injury and/or death, property loss and/or damage and/or the injury and/or harm of another person, and/or their property and/or any legal fees arising from any claims which result from participating in this outing. This agreement shall be subject to the laws of the County of Alachua and the State of Florida. If any provision of this agreement is determined to be outside the scope of those laws, all other provisions shall be given full force and effect and will not negate this agreement in its entirety. In the event I would need to be reached during the outing, I will be at one of the following number(s): _____________________ Home
_____________________ Work
_____________________ Other Number
_________________________ Participant Name
_________________________ Participant Signature
_______________ Date
_________________________ Parent Name
_________________________ Parent Signature
_______________ Date
_________________________ Notary Signature
_______________ Date
(notary seal)
