Place/Nature of Activity:
Any and all YOKE sponsored activities such as leadership weekends, camps, summer activities and club activities for 2020-2021
I understand that the activities referred to in this form are potentially hazardous activities. I acknowledge that I am medically and physically able to withstand the rigors of such activities. I assume any and all risk associated with these activities.
I release YOKE and each of its individual agents, and the co-sponsoring organization, if any, and each of its individual agents, from any and all liability for personal injury (including death) to, or caused by, myself, and for all property damage. I assume all risk of such injury or damage, and will hold YOKE and each of its individual agents, and all parties in any way connected with YOKE, harmless from all loss and damage whatsoever, in consideration of YOKE’s allowing me to participate in such activities.
In case of emergency, I understand that every effort will be made to contact my emergency contacts listed below. If such contact is not possible, I give YOKE permission to act in seeking emergency medical treatment for me in the event that such treatment is deemed necessary by YOKE. This permission is also directed to those administering emergency treatment, using such measures as they deem necessary. I assume all risk associated with such measures and actions, and will hold YOKE and its individual agents, and the co-sponsoring organization, if any, harmless from all loss and damage whatsoever, resulting from such measures or actions.
Please list any pertinent medical information including medical history, medications, allergies, and emergency care instructions (EpiPen): Please respond "None" if this does not apply
I hereby (Give / Do Not Give) YOKE Youth Ministries full unrestricted rights to publish, copyright, distribute electronically and/or use any still or motion pictures, photograph of myself for use in editorial content, art, advertising, trade or any other lawful purpose. I understand my likeness may be used in advertising and/or promotions. I hereby release and hold harmless the above named, its successors, employees, agents, and assigns from any liability or claims or damage whatsoever in connection with said use of my likeness. I waive any right to inspect and approve final use of materials covered hereunder. I certify that I am 18 years of age and have included my name and signature appear below. I have read and understand this Release, and certify that the information provided is true and accurate.
