Liability Waiver/Medical Treatment Consent
In order for us to process your registration, you must sign the Liability Waiver / Medical treatment consent after you have read and agreed to the terms. Registrations where the waiver/consent has been altered will not be processed.
In consideration for my and/or any of my family members participation in FCA Summer 2024 Soccer Camp at Heart & Soul Community Church at 1185 N Clinton Ave, Rochester, NY 14609 that I wish to register for, I voluntarily RELEASE Fellowship of Christian Athletes (FCA) and Heart & Soul Community Church and their CHURCHES, OFFICERS and VOLUNTEERS (hereinafter referred to as “Releasees”) from any and all liability for injuries or death or property damage to me and/or my family members resulting from, arising out of, or in any way connected with my and/or any of my family members participation in the Heart & Soul Community Church/FCA activity, or the use of any of the facilities in connection with this program. I understand that this WAIVER and RELEASE is applicable even though the negligent activities of the RELEASEES may have contributed to the injury or death or property damage suffered by me or any of my family members participating in this program. I further agree to INDEMNIFY and HOLD HARMLESS the RELEASEES from and against any and all liability, claims, causes of action, and/or losses of any nature or kind (including litigation-related expenses such as attorney and expert witness fees) resulting from participation in this program whether caused by any negligent act or omission of the RELEASEES.
I further understand that serious accidents may occur in the Heart & Soul Community Church/FCA activity that I am registering for, that participants in this program may sustain mortal or serious personal injuries, and/or property damage, as a consequence of their participation in this program. Knowing the risks of said event, nevertheless, I HERBY AGREE TO ASSUME THOSE RISKS AND TO RELEASE AND HOLD HARMLESS TO THE FULLEST EXTENT ALLOWED BY LAW ALL OF THOSE PERSONS MENTIONED ABOVE WHO THROUGH PASSIVE OR ACTIVE NEGLIGENCE OR CARELESSNESS MIGHT OTHERWISE BE LIABLE TO ME FOR DAMAGES.
It is further understood and agreed that this waiver, release, hold harmless and indemnification agreement is to be binding on me, any of my participating family members, and all of our heirs, representatives, and assigns.
I hereby authorize qualified physicians to render medical treatment or care that they may deem necessary for me or my family members in case of illness or accident during such program(s). In the event of injury, and if a parent cannot be reached, emergency services will be contacted to transport the injured to the nearest hospital.
By checking the box below, I signify that I have read, understand, and voluntarily agree to be bound by each of the terms stated above.
By checking the box below, the guardian listed above understands and agrees that photographs may be taken during recreation programs and the undersigned hereby gives permission to have photos taken and authorizes the use and reproduction of said photos by Heart & Soul Community Church and Fellowship of Christian Athletes. All image files and prints are the property of Heart & Soul Community Church and Fellowship of Christian Athletes