While I understand that every reasonable precaution will be taken, in the event of an emergency I authorize any member of the VBS staff to get emergency help for my son/daughter as is deemed appropriate.

I understand that every attempt will be made to contact me in case of an emergency.

I understand that my child may be photographed during VBS and those photographs may be used for promotional materials for the church (perhaps in the Lamplighter or on the church’s website). Your child’s name will not accompany the photographs online.

I give my permission for him/her/myself to accompany pastors, youth advisors, and/or recognized youth chaperones of St. Peter’s United Church of Christ on Church sponsored youth outings and activities. I understand there are dangers and risk of injury inherent in participating in these youth outings and activities, but still desire to allow the above named youth to participate in such
activity.

Therefore, the undersigned, for and in consideration of the opportunity to allow the person to participate in 
outings and activities, and for other good and valuable consideration, does hereby forever release, quit and forever discharge St. Peter’s United Church of Christ, it pastors, youth advisors, employees, insurers, agents, servants, and recognized chaperones (hereafter referred to as “Released Parties”) from any and all claims, demands, rights and causes of action of any kind or arising out of any and all known and unknown, foreseen or unforeseen bodily and personal injuries, property damage or the consequence thereof, resulting from any accident, casualty or event involving the above named participant and arising out of participating in Church sponsored youth outings and activities.

I UNDERSTAND THIS MEANS I AGREE NOT TO SUE ANY AND ALL OF THE RELEASED PARTIES FOR ANY INJURIES OR PROPERTY DAMAGE RESULTING TO THE ABOVE NAMED PARTICIPANT DURING OR IN CONNECTION WITH HIS OR HER PARTICIPATION IN CHURCH SPONSORED OUTINGS AND ACTIVITIES.

I understand this Release does not waive liability for intentional reckless acts, as such claims cannot be waived, but do understand this Release waives claims of any other kind, specifically including claims for negligence, against the Released Parties.

FURTHER AND BY WAY OF INDEMNITY, the undersigned hereby expressly understands and agrees to indemnify and hold harmless the Released Parties, their employees, agents, or insures, against any and all claims for damages, costs or expenses, incurred by the Released Parties, their employees, agents or insures, as a result of any accident or injury which might occur while the above named participant is participating in Church sponsored outings and activities and which may result from the negligence of the Release Parties, their employees, and agents, third parties or any combination thereof.

By submitting this form, I declare and represents that no promise, inducement or agreement not contained in this written agreement has been made to the submitter and that this Release contains the entire agreement between the parties and the terms of the Release contractual and not mere recital. The submitter further acknowledges the opportunity to negotiate this Release with an authorized member of St. Peter’s United Church of Christ.