MINOR WAIVER + PERMISSION FORM

Legal Guardian - First Name

Legal Guardian - Last Name

Form Date

Students Full Name

Students Grade

Birthdate

Gender

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Please Check Box to Consent

I, being the parent or legal guardian of the student listed in this form have been informed of the event: City Week 2025 which is organized by ASCEND Student Ministry / Grace World Outreach Church and hereby give my consent for my minor child to participate in this event.

Signature

Please Check Boxes to Consent

I understand that all reasonable safety precautions will be taken by the leaders of this event referenced above, and that the possibility of an unforeseen hazard does exist. In consideration of your minor child being permitted to participate in the event and any related activities (collectively, the "Event"), wherever the Event may occur, you hereby attest that, after reading this Waiver and Permission Form completely and carefully, including the notice above your signature, as required by Florida Statutes 744.301, you acknowledge that participation in the Event by your child is entirely voluntary, and that you understand and agree as follows:

RELEASE OF LIABILITY:

I agree, on behalf of my child, to waive and release all liabilities, claims, actions, damages, costs or expenses of any nature ("Claims") associated with all risks that are inherent to his or her participation in the Event or other activities conducted in conjunction therewith (which risks may include, among other things, exposure to coliform bacteria, muscle injuries, heat and stress related issues, cuts, lacerations and broken bones), whether such risks are open and obvious or otherwise. Further on behalf of myself, I hereby release, covenant not to sue, and forever discharge the Released Parties (as defined under "INDEMNITY" below) of and from all Claims arising in any manner out of or in any way connected with my child's participation in the Event.

INDEMNITY:

I agree to indemnify and hold GRACE WORLD OUTREACH CHURCH and their respective parent, subsidiary and other affiliated or related companies, and the officers, directors, employees, agents, contractors, subcontractors, representatives, successors, assigns, and volunteers of each of the foregoing entities (hereafter collectively referred to as the "Released Parties") harmless from and against any and all Claims arising out of or in any way connected with my child's participation in the Event, wherever the Event may occur, including, but not limited to, all attorneys' fees and disbursements through and including any appeal. I understand and agree that this indemnity includes any Claims based on the negligence, action or inaction of any of the Released Parties and covers bodily injury (including death), property damage, and loss by theft or otherwise, whether suffered by me or my child either before during or after participation in the Event.

PHYSICAL CONDITION/MEDICAL AUTHORIZATION:

I hereby certify that my child is physically fit for participation in the Event and has the skill level required in connection with the Event, and I have not been advised otherwise. I agree that before my child participates in any activity conducted in conjunction with the Event, I or my child or ward will inspect all related facilities and equipment. In connection with any injury sustained or illness or medical conditions experienced during my child's attendance in connection with the Event, I authorize any emergency first aid, medication, medical treatment or surgery deemed necessary by the attending medical personnel if I am not able to act on my child's behalf. Additionally, I authorize medical treatment for my child, at my cost, if the need arises; however, I acknowledge that the Released Parties will have no duty, obligation or liability arising out of the provision of, or failure to provide, medical treatment.

EQUIPMENT AND FACILITIES INSPECTION:

I, or my child, if I am not in attendance at the Event, will immediately advise the Event manager of any unsafe condition that I, or my child, if I am not in attendance at the Event, observe. My child will refuse to participate, and I will refuse to let my child participate, in the Event until all unsafe conditions observed by me, or my child, have been remedied.

GOVERNING LAW:

This Waiver and Permission Form will be governed by the laws of the State of Florida, and any legal action relating to or arising out of this Waiver and Permission Form will be commenced exclusively in the Circuit Court of the Ninth Judicial Circuit in and for Orange County, Florida (or if such Circuit Court does not have jurisdiction over the subject matter thereof, then to such other court sitting in such county and having subject matter jurisdiction), AND I SPECIFICALLY WAIVE THE RIGHT TO TRIAL BY JURY.

NOTICE TO THE MINOR CHILD'S NATURAL GUARDIAN(S) REQUIRED UNDER FLORIDA STATUTES 744.301 - PLEASE READ BEFORE SIGNING

YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY. YOU ARE AGREEING THAT, EVEN IF GRACE WORLD OUTREACH CHURCH AND EACH OF THE RELEASED PARTIES USE REASONABLE CARE IN PROVIDING THIS ACTIVITY, THERE IS A CHANCE YOUR CHILD MAY BE SERIOUSLY INJURED OR KILLED BY PARTICIPATING IN THIS ACTIVITY BECAUSE THERE ARE CERTAIN DANGERS INHERENT IN THE ACTIVITY THAT CANNOT BE AVOIDED OR ELIMINATED. BY SIGNING THIS FORM YOU ARE GIVING UP YOUR CHILD'S RIGHT AND YOUR RIGHT TO RECOVER FROM GRACE WORLD OUTREACH CHURCH AND THE RELEASED PARTIES IN A LAWSUIT FOR ANY PERSONAL INJURY, INCLUDING DEATH, TO YOUR CHILD OR ANY PROPERTY DAMAGE THAT RESULTS FROM THE RISKS THAT ARE A NATURAL PART OF THE ACTIVITY. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM, AND GRACE WORLD OUTREACH CHURCH HAVE THE RIGHT TO REFUSE TO LET YOUR CHILD PARTICIPATE IF YOU DO NOT SIGN THIS FORM.

By signing below, I certify that: (1) I have fully and completely read and understand this Waiver and Permission Form; (2) I am 18 years of age or older; (3) I am the legal guardian of the minor child identified above; (4) the information set forth above pertaining to my child is true and complete; and (5) I consent and agree to the all of the foregoing on behalf of myself and my minor child identified above.

Please check box to consent.

Printed First Name

Printed Last Name

Waiver + Permission Form

< Back

Next >

Submit