Trip Or Activity Liability Release Form printable pdf download

LIABILITY RELEASE FORM

Release of All Claims

In consideration for being accepted by Fair Lawn United Methodist Church, Columbia, SC for participation

in the paintball event at Trigger Tyme Paint Ball, November 20, 2010, I (we), being 21 years of age or

older, do for myself (ourselves)(and for and on behalf of my (our) child-participant if said child is not 21

years of age of older) do hereby release, forever discharge and agree to hold harmless Fair Lawn United

Methodist Church and the directors thereof from any and all liability, all claims or demands for personal

injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be

incurred by the undersigned and the child-participant that occur while said child is participating in the

above-described trip or activity.

* Furthermore, I (we)(and on behalf of my (our) child-participant if under the age of 21 years) hereby

assume all risk of personal injury, sickness, death, damage and expense as a result of participation in

recreation and work activities involved therein.

* Further, authorization and permission is hereby given to said church to furnish any necessary

transportation, food and lodging for this participant.

* The undersigned further hereby agree to hold harmless and indemnify said church, its directors,

employees and agents, for any liability sustained by said church as the result of the negligent, willful or

intentional acts of said participant, including expenses incurred attendant thereto.

(If the participant has not attained the age of 21 years):

* I (We) am (are) the parent(s) or legal guardian(s) of this participant, and hereby grant my (our)

permission for him/her to participate fully in said trip, and hereby give my (our) permission to take said

participant to a doctor or hospital and thereby authorize medical treatment, including but not in limitation to

emergency surgery or medical treatment, and assume the responsibility of all medical bills, if any.

* Further, should it be necessary for the participant to return home due to medical reasons, disciplinary

action or otherwise, I (we) hereby assume all transportation costs.

________________________________________

Participant’s name (type or print)

__________________________________________

Parent's telephone number

_________________________________________

Insurance Company ........... Policy Number ....

_________________________________________

Physician ........... Physician's Telephone Number ..

Only participant need sign if 21 years of age or older.

If participant is under 21, a parent or legal guardian must sign.

__________________________________________

Parent or Legal Guardian............... Date ..

__________________________________________

Participant (if 21 years old) .......... Date ..

I have read the foregoing and understand the rules of conduct for participants and will abide by them as

well as the directions of the leadership of the trip.

_____________________________________________________

Participant

Trip Or Activity Liability Release Form