Adult Event WaiverParticipant InformationInsurance InformationEmergency Information
If I am incapacitated because of an emergency, please contact:Release of Liability
In consideration for my being allowed to participate in any and all activities, I, for myself, my heirs, executors, administrators, assigns or personal representatives, release from liability and waive my right to sue Grace Community Church of Riverside, their employees, officers, volunteers and agents (collectively GCC) from any and all claims, including claims of GCC’s negligence, resulting in any physical injury, illness (including death), or economic loss I may suffer
or which may result from my participation in activities, travel to and from activities (including air travel), or any events incidental to activities.
EXPRESSED ASSUMPTION OF RISK:
I am voluntarily participating in activities. I understand that there are risks associated with participation in activities, such as physical and/or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability, paralysis, death or economic loss. These injuries or outcomes may arise from Participant’s own or other’s actions, inactions, or negligence, or the condition of the activities’ location (s), facility (ies), dangerous or defective equipment or property owned, maintained or controlled by GCC. Nonetheless, I assume all risks for Participant’s participation in activities, whether known or unknown to me, including travel to and from activities or any events incidental to activities.
INDEMNIFY AND HOLD HARMLESS:
I agree to hold GCC harmless from any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney’s fees and any related costs, as a result of my participation in activities, including travel to and from activities or any events incidental to activities. If GCC incurs any of these types of expenses, I agree to reimburse GCC.
I acknowledge that GCC is NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf.
I understand while participating in activities, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns.
I hereby consent to receive medical or dental treatment which may be deemed advisable by the medical personnel and representatives of GCC in the event of injury, accident, and/or illness during activities.
If I need medical treatment as a result of my participation in activities, travel to and from activities, or any events incidental to activities, I agree to be financially responsible for any costs incurred as a result of such treatment.
I am aware that I should carry my own health insurance.
UNDERSTANDING AND ACKNOWLEDGEMENT:
I am 18 years of age or older. I have read this document, and I am signing it freely. I understand the legal consequences of signing this document, including (a) releasing GCC from all liability on my behalf, (b) waiving my right to sue GCC, (c) and assuming all risks of my participation in activities, including travel to and from activities (including air travel) or any events incidental to activities. I understand that I am responsible for my obligations and acts as described in this document. I agree to be bound by the terms of this document. No other representations concerning the legal effect of this document have been made to me.
I understand that this document is written to be as broad and inclusive as legally permitted by the State of California. I agree that if any portion is held invalid or unenforceable, I will continue to be bound by the remaining terms.
Please type name as legal signature (Cal ETA, Civil Code Section 1633.7. Section 1633.7).