Release and Authorization
I, being 18 years of age or older, do hereby consent to participation of my child (or myself) (“participant”) in the King of Kings Lutheran Church Peak Challenge Experience to Leadville, Colorado on July 30th to August 3rd, 2015.
Participant releases and forever discharges The Lutheran Church – Missouri Synod and King of Kings Lutheran Church, Omaha Nebraska, their agents and servants, successors and assigns, directors, trustees, officers, employees, and other representatives, including the Band of Brothers Network and any of its representatives or agents from any and all damages and causes of action either at law or in equity that participant may have as a result of my child’s (or my) participation in, attendance at, and travel to and from the trip.
Participant does hereby expressly stipulate, and agree to indemnify and hold forever harmless The Lutheran Church – Missouri Synod and King of Kings Lutheran Church, Omaha Nebraska, its agents and servants, successors and assigns, directors, trustees, officers, employees, and other representatives including the Band of Brothers Network and its representatives and agents against loss from any and all present or future claims, demands or actions in law or in equity that may hereafter be made or brought by me or my child, by anyone on behalf of my child or me, or by anyone else on their own behalf for damages or any other legal or equitable remedy on account of any injury, illness, physical condition, inconvenience or loss sustained by my child or me during the trip or travel to and from the same.
Participant hereby assumes all risk of personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein.
Participant authorizes and herby gives permission to King of Kings Lutheran Church and its authorized representatives to furnish any necessary transportation, food, and lodging for this participant.
Participant agrees to hold harmless and indemnify King of Kings Lutheran Church, and its directors, employees, trustees, officers, directors, successors, assigns, agents and other representatives, including the Band of Brothers Networkand its representatives and agents, for any liability sustained by the above parties as a result of the negligent, willful or intentional acts of said participant including expenses incurred attendant thereto.
Should it be necessary for participant to return home due to medical reasons or otherwise, participant hereby assumes responsibility for all transportation and medical costs.
The participant enters this agreement with the full awareness of the inherent risks incidental to such a trip. The participant understands and acknowledges that the conditions in some of the places to be traveled / visited may not meet the same standards to which the participant is accustomed. There may be health risks and hazards associated with food, water, altitude and transportation, as well as other risks. Participant agrees to participate in this trip being aware of such risks and expressly agree to assume all risks.
Further, participant grants to King of Kings Lutheran Church and its authorized representatives, including Band of Brothers Networkand its representatives and agents, the right to use photographs and/or videos or audio of me and my child taken on this trip. Participant grants the right to King of Kings Lutheran Church and its authorized representatives, including Band of Brothers Network and its representatives and agents, to reproduce, publish, circulate, sell and otherwise use on behalf of King of Kings Lutheran Church and its authorized representatives, including Band of Brothers Network and its representatives and agents, any and all photographic and video likenesses. Participant waives any right to inspect the final artwork or copies prior to any publication contemplated herein and acknowledges that the rights granted herein are perpetual and not limited in time.
The undersigned hereby acknowledges that he has read the foregoing, understands its contents, and has signed the same as his own free act and deed.
Print Name of Participant______Signature of Participant______
Print Name of Parent/Guardian and the child’s name (if participant is less than 18 years of age)______
Signature of Parent/Guardian______