Release Form for Parent/Guardian/Young Adult(18 and over) for Project Restore
This form is for participants 18 and over (not participating as a team leader) OR for parents of participants under 18 years of age
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Name of parent/guardian (or name of participant 18 or older completing the form) *
Project Restore Info
Name of participant *
GENERAL RELEASE - Project Restore Mission and Travel: In consideration of being permitted to participate in Project Restore 2023 as presented by Lighthouse Ministry Inc.,  New Jersey not-for-profit Corporation, (hereafter “Lighthouse”), I, for myself, personal representatives, heirs, executors, administrators and assigns, do hereby RELEASE, WAIVE, DISCHARGE, and COVENANT NOT TO SUE Lighthouse, First Presbyterian Church, project leaders, officers, staff, youth leaders, directors, and any and all other members of Lighthouse or First Presbyterian Church, and/or other churches participating from all liability to myself, and for all loss or damage on account of injury to my person and property, or resulting in my death, while I am preparing for, traveling to and from, and participating in the Service Week. I, my personal representatives, heirs, executors, administrators and assigns, do hereby agree to indemnify and defend Releasees, from any loss, liability, damage, or cost Releasees may incur due to my preparation for, traveling to and from, and participating in Project Restore. If this form is signed by a parent for a child under the age of 18, then such parent agrees to indemnify and defend Releasees from any loss, liability, damage or cost Releasees may incur due to any claim made by or on behalf of such child.  This form will also authorize emergency medical personnel, licensed physicians, or other hospital staff, to carry out emergency medical care deemed necessary for my child in an emergency when normal permission is unavailable. I acknowledge that there are certain dangers inherent to Project Restore, such as (but not limited to) traveling in vans and construction activities. I also acknowledge that my own personal physical condition, general athletic ability, and health will be factors in my participation in Project Restore. I acknowledge that I am the best judge of my own abilities and limitations, and I assume the risks of participation in all activities in which I may participate. I represent that my health and physical condition will allow me to fully participate in Project Restore. I acknowledge that I may refuse to perform any activity which I may be requested to perform, and that I may withdraw from Project Restore at any time at my sole discretion. I have been advised that Lighthouse, and its leaders will presume that I am capable of participating in all such activities unless I specifically advise them otherwise. This General Release shall pertain and remain in full force and effect so as I am participating in any part of Project Restore, now and at any future date. I have carefully read the above Release and I know the contents of it, and I sign this Release as my own free act.  If I am signing this Release on behalf of a child, I acknowledge that I have legal authority to do so as either parent or legal guardian of such child. *
Please list any restrictions in activities or respond "NA" *
Please list any food or environmental allergies, other dietary restrictions, or respond "NA" *
Photo Consent: I give permission to have my child's image and/or voice photographed or recorded and grant Lighthouse Ministry all rights to use these recordings or photographs in any medium for educational, promotional, advertising, or other purposes that support the mission of the ministry. If I, the volunteer am 18 or older, I give my own consent.                                 *
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