Registrant
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I acknowledge that participation in the Senior Retreat with Mountain Students involves risk to the participant (and to the participant’s parents, guardians, and family members), and may result in various types of injury including, but not limited to, the following: sickness, exposure to infectious/communicable disease, bodily injury, and personal injury. In consideration for the opportunity to participate in the Senior Retreat, the participant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the activity. The participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the Senior Retreat or during transportation to and from the activity, as well as for any medical treatment rendered to the participant that is authorized by the church staff or volunteers. By checking this box, I agree to the above terms and conditions.
Please indicate whether you agree: I give permission for medical attention to be given to my son/daughter in case of injury, including major surgery. I understand that I will be contacted as soon as possible in case of an incident.
Please indicate whether you agree: I understand that there may be occasions when Mountain Christian Church (“MCC”) will want to use photographs or audio or video recordings from Church activities or events in which I participate. I grant to MCC the right to include photographic, video, audio and other visual or audio portrayals of me taken during or in connection with Church activities or events in any medium of any nature whatsoever (including the right to edit, combine with other materials or create any type of derivative thereof) for the purpose of advertising, publicity, promotions, or otherwise, without compensation to me. Such grant shall include the unrestricted right to copy, revise, distribute, and display photographs, images, films, tapes, drawings or recordings in any type of media (including, but not limited to, the Internet). I consent to the use by MCC of my testimonial, comments and/or narrative writing in any manner, free of charge, in any form or media. I understand the wording of any testimonial, comments and/or narrative writing may be edited or altered, provided that the sense and meaning are not materially changed. I agree that all rights, title and interest therein shall be MCC’s sole property, free from any claims by me or any person deriving any rights or interest from me. I release MCC and its agents and assigns from any and all claims which may arise out of or are in any way connected with such use.