RELEASE, WAIVER, AND INDEMNITY AGREEMENT

Parent or Guardian of Minor *
Parent or Guardian of Minor
Name of Minor *
Name of Minor
Date *
Date
*
IT IS THE INTENTION OF (PARENT OR GUARDIAN OF MINOR above) BY THIS AGREEMENT TO EXEMPT AND RELIEVE The Movement Church AND ITS OFFICERS, AGENTS, SERVANTS, OR EMPLOYEES FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE, OR WRONGFUL DEATH OF (NAME OF MINOR above) CAUSED BY ANY ACT OF NEGLIGENCE OF The Movement Church AND ITS OFFICERS, AGENTS, SERVANTS, OR EMPLOYEES. For and in consideration of permitting (NAME OF MINOR) to observe, or use any facility or equipment of The Movement Church, or engage in and/or receive instruction in any activity or activity incidental thereto SOME OF WHICH MAY INVOLVE DANGERS AND RISK OF BODILY INJURY at: The Movement Church in the city of Laguna Niguel,, County of Orange, and State of CA, beginning on the date of this form for one year, the undersigned parent and/or guardian of (NAME OF MINOR): hereby voluntarily and absolutely releases, discharges, waives, and relinquishes any and all loss or damages or actions or causes of action for personal injury, property damage, or wrongful death occurring to (NAME OF MINOR) as a result of (NAME OF MINOR)'s observing or using facilities or equipment of The Movement Church, or engaging in or receiving instructions in any activities SOME OF WHICH MAY INVOLVE DANGERS AND RISK OF BODILY INJURY or in activities incidental thereto wherever or however the same may occur, and for whatever period said activities or instructions may continue. The undersigned parent or guardian of (NAME OF MINOR) for him/herself, his/her heirs, executors, administrators, or assigns agrees that in the event any claim for personal injury, property damage, or wrongful death shall be prosecuted against The Movement Church or its officers, agents, servants, or employees, the undersigned parent or guardian will indemnify and hold harmless The Movement Church and its officers, agents, servants, or employees from any and all claims or causes of action by (NAME OF MINOR) or by any other person or entity, by whomever or wherever made or presented, and under no circumstances will the undersigned parent or guardian of (NAME OF MINOR) present any claim against The Movement Church and said persons for personal injuries, property damage, wrongful death, or otherwise, caused by any act of negligence by The Movement Church and said persons. The undersigned parent or guardian represent that he/she has read this Release, has requested and has been provided with, or has requested and declined advisement on the potential dangers/risks of engaging in the observation, activities, or instruction offered, assumes all risks associated with such dangers and risks, and is fully aware of and understands the terms and the legal consequences of the signing of this Release. The undersigned parent or legal guardian intends his or her signature to be a complete and unconditional release of all liability to the greatest extent allowed by law and if any portion of the Release is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.