1. I release from all liability and indemnity The International Church of the Foursquare Gospel, New Song Christian Fellowship, Garner Creek Retreat Center, its directors, officers, council, agents, representatives, volunteers, and employees (all of which will be referred to as "Church") from any and all liability, claims, judgments, cost or expenses, including attorney fees, arising out of any damage, injury or illness incurred or caused by my child(ren) while participating in or traveling to or from the activity, or otherwise in Church custody. I understand the risks in these activities, including the possibility of unforeseen hazards, serious injury or death. I certify my child(ren) is (are) able to participate in the activity.
2. I agree to instruct my child to cooperate with the Church and its representatives in charge of the activity and understand my child(ren) may be prohibited from participating and/or sent home for any failure to follow the rules established by the Church.
3. I appoint Church representatives who are acting as leaders, or designated by such leaders, as my attorney in fact to act for me in my name and on my behalf, in any way that I could act if I were personally present, with respect to the following matters if any injury, illness or medical emergency occurs during the activity, related travel, or while my child(ren) is (are) in Church custody.
a. To give any and all consents and authorizations to any physician, dentist, hospital or other persons or institutions pertaining to any emergency actions as our medical attorneyinfact shall deem necessary or appropriate for the best interest of the child(ren).
b. I understand the Church will make a reasonable attempt to contact me as soon as possible in the event of a medical emergency involving my child(ren).
4. I agree that the Church may use my child(ren)’s and/or my own name, voice, portrait, photograph or image for promotional, website, office or any other churchrelated purposes. These may be used in any broadcast, telecast, digital or print medium, including video images, photographs, pictures or rendering, audio recording, or other likenesses, in combination or alone.
5. I agree that I am fully responsible for all medical expenses not covered by insurance.