Medical and Liability Release

FIRST UNITED METHODIST CHURCH, Georgetown Texas

May 2017-July 2018

 

Liability Release Agreement
  • The undersigned (whether one or more, called “Parent”) gives permission for the child listed above (the “child”), to attend and participate in activities sponsored by First United Methodist Church (“FUMC”), including, without limitation, for the child to travel outside of Texas and the United States of America on FUMC trips.
  • Parent authorizes an adult, in whose care the child has been entrusted, to consent to any examination, anesthetic, medical, surgical, or dental treatment, including, without limitation, hospital care, to be rendered to the child under the general or special supervision and on the advice of any physician, dentist, hospital, or other professional.
  • Parent shall pay all costs and expenses incurred in connection with any medical and dental services rendered to the child under this authorization. If it becomes necessary for the child to return home for any reason, Parent has responsibility for all transportation costs.
  • FUMC may use the child’s picture and statements in promotional materials approved by FUMC.
  • PARENT FULLY UNDERSTANDS that: (a) FUMC’s activities involve risks and dangers of SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH (“Risks”); (b) these Risks may be caused by the child or by the actions or inactions of others participating in or supervising the activity, the condition in which the activity takes place, or THE NEGLIGENCE OF THE “RELEASEES” NAMED BELOW; (c) there may be other risks and social and economic losses, both known or not readily foreseeable at this time; and PARENT, ON BEHALF OF ITSELF AND CHILD, FULLY ACCEPTS AND ASSUMES ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES incurred as a result of the child’s participation in these activities.
  • PARENT, ON PARENT’S BEHALF AND ON BEHALF OF PARENT’S EXECUTORS, ADMINISTRATORS, AGENTS, HEIRS, ASSIGNS, DESCENDANTS, REPRESENTATIVES AND TRANSFEREES (THE “RELEASING PARTIES”) HEREBY RELEASES, DISCHARGES, COVENANTS NOT TO SUE, AND AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS FUMC, its respective administrators, directors, agents, officers, volunteers, employees, predecessors, assigns, successors, representatives, transferees, and other participants (each a “Releasee”) from all obligations, causes of action, claims, demands, lawsuits, grievances, judgments, costs, expenses, attorney’s fees, losses, damages, and liabilities (whether known or unknown, suspected or unsuspected, accrued or unaccrued, whether at law, equity, administrative, statutory or otherwise, and whether for injunctive relief, actual damages, compensatory, punitive, or any other kind of damages, and SPECIFICALLY INCLUDING ANY CLAIMS FOR NEGLIGENCE) that may be incurred by or asserted against the Releasees, or any of them, or which any of the Releasing Parties ever have had in the past or  presently has against the Releasees, or any of them arising from or relating to all personal injuries, illness, pain, suffering, death, property damage or property theft (real or personal), or actions of any kind caused by, or arising out of, the child’s participation in FUMC activities. Releasing Parties specifically waives all rights to any civil, legal, or equitable claim for special, indirect, incidental, or consequential damages against the Releasees.
  • The Releasing Parties agree that, from the date of this Agreement, the Releasing Parties will not commence, maintain, initiate, or cause, encourage, assist, volunteer, or advise any other person to commence, maintain, initiate, or prosecute, any action, suit, proceeding, or claim relating to any of the matters released.
  • Further, authorization and permission is hereby given to FUMC to furnish any necessary transportation, food, and lodging for this participant, and Parent grants its permission for the child to participate fully in any FUMC trip or activity. The child may ride in any vehicle designated by an adult in whose care the child has been entrusted while attending and participating in activities sponsored by FUMC.
  • If it becomes necessary for the participant to return home for any reason, Parent shall immediately transport the child home, assume all transportation costs, and acknowledges that Parent shall not receive a refund for any part of the activities that the participant did not complete nor for any related transportation costs.
  • The terms of this Agreement shall remain valid and in-force until Parent gives written notice otherwise to FUMC.
  • Parent represents that Parent is the parent or legal guardian of the child named above, and is authorized to enter into this agreement on behalf of Parent and the child. 
For Student Participants – Behavior Covenant:

I agree to abide by all rules and directions that FUMC leaders deem appropriate (i.e., no drugs, alcohol, weapons, tobacco, etc.).  I recognize that failure to do so could result in my expulsion from the activity/event, at my parent(s)’ expense, with no refund, and that my parents may have to pick me up immediately, regardless of the time of day or night.

As a member of the Body of Christ, I covenant to conduct myself in a way that brings honor to God. As a person representing FUMC, I covenant to treat those we meet and serve in a kind, honorable, and respectful manner.

As a member of FUMC, I covenant to treat myself and others with respect and love. I understand that it is my job to check the daily schedule and know my responsibilities.

 Ibuprofen
 Tylenol
 Benadryl
 Pepto Bismol
 Immodium
 Neosporin Ointment
login