Registration

I Hereby give my permission for myself and/or my child to participate in an activity organized by New Grace Church, Inc. d/b/a Grace Anglican Church (herein GAC). I hereby release, hold harmless and absolve GAC, their officers, staff, sponsors, vendors, and all others who have participated in the planning, organizing and implementing of the activity, be they individuals or organizations, singly or collectively, from responsibility and liability for any illness, injury, misadventure, harm, loss or inconvenience suffered or sustained as a result of the participation during the camp. I understand that in the event I or my child requires medical treatment while engaged in the activity, reasonable efforts will be made to contact my designated emergency contacts; however, if they cannot be reached, I hereby consent and give my permission to the GAC staff or any adult counselor acting on behalf of GAC with respect to the activity, to consent to any X-ray examination, medical, dental or surgical diagnosis; treatment; and hospital care advised and supervised by a physician, surgeon or dentist (as appropriate) licensed to practice under the laws of the state where the services are rendered, either as an outpatient or in any hospital. To the best of my knowledge, I have listed below all my child’s medical allergies, medications being taken, medical problems and other pertinent information. I hereby represent that I have, or my child has the experience and is physically and mentally capable to engage in Event Activities, and further represent that my child has no physical or mental limitations to prevent me or my child from engaging in the Event Activities. Finally, I agree that GAC may tape or photograph my child and record his or her voice during their participation in the activity. I agree that GAC will be able to use them, in whole or in part, whether in original or modified form in any manner or media, including without limitation, for the purpose of advertising, promoting, and publicizing GAC whether during the activity or thereafter. I hereby release and discharge Gulf Atlantic Diocese, Headquarters Tallahassee, FL and GAC located in Fleming Island, FL and all affiliated entities from any and all claims, demands, or causes of action that I have in connection with the use and exercise of the rights granted in this release. FOR PARENTS: I/we have read this document and understand it. I/we hereby give permission for my student to attend this activity and in event of an accident or illness, permission for the student to receive emergency medical treatment as deemed necessary by a licensed physician or medical personnel. It has been explained to me/us that participation in this activity may expose the student to risk of personal injury and damage to his/her property. In exchange for GAC allowing the student to participate in the activity, I/we agree (a) that GAC, its members, ministers, board, agents, and employees will NOT be liable to me/us for injury to me/us, the student, his/her property, or my/our property arising out of, or occasioned by, directly or indirectly, the student’s participation in the activity, and (b) that it is my/our intent to release GAC, its members, ministers, board, agents, and employees from liability even if the personal injuries or property damage is caused by the sole negligence or contributory negligence of GAC, its members, ministers, board, agents or employees.