Grace and Peace Church - Element Waiver

Element Wavier

Waiver form for any activity outside of the church building including Sports Facility.
“The Element” wants your child’s experience to be a safe and healthy one. However, in the event of an accident or illness, it is important that we have the following information:
For contact please put student and "add another person" for parent info.

First Name

Last Name

Phone Number

Date of birth

Gender

Any allergies or any medical needs?

Any limits to activities?

Any information you would like us to know?

INDEMNITY AND CONTRACT AGREEMENT:
I will not hold or attempt to hold The Grace and Peace Community liable for any loss, damage, or injury to person or property caused by any act or neglect of other persons, or caused in any manner other than the willful or negligent act of The Grace and Peace Community, its agents and employees, and will indemnify and hold The Grace and Peace Community harmless from any liability for damages or claims against The Grace and Peace Community arising out of or in any way related to any such loss, damage or injury.
I release The Grace and Peace Community, including its board, employees and leaders, from me or my child’s physical injury, including death, or illness while at the activity. I/We will assume the risk associated therewith, whether known or unknown to me/us at this time. This release is also intended to include all claims of my family, estate, heirs, personal representatives or assigns.
I verify that I or child named above is in good health and capable of participating in strenuous activities and, when necessary, will tailor my/their activities to those within the bounds of my/their physical health.

Parent Signature