Truth Baptist Church • 60 Burnham Street • South Windsor, CT 06074
ACKNOWLEDGMENT OF RISK AND WAIVER OF LIABILITY To:
TRUTH BAPTIST CHURCH, their officers, directors, trustees, affiliates, managers, employees, volunteer staff, agents and their successors and assigns (collectively and individually referred to as “TBC”:
The undersigned, on behalf of their child (individually and collectively referred to as the “Releasor”) acknowledges that Releasor will participate in numerous activities that may involve risk of injury to person or property and that he or she assumes full responsibility for all such risk. Other than as set forth below, the undersigned certifies that the Releasor is in good health with no condition, illness or abnormality which might subject him or her to undue personal risk from engaging in such activities. In the event of any emergency requiring medical care, TBC is hereby authorized to use its best efforts to obtain whatever medical treatment it deems necessary or appropriate. Furthermore, the Releasor hereby specifically agrees to forever release, waive, indemnify, save and hold harmless, discharge and covenant not to sue TBC with respect to any or all liability to the Releasor, his or her representatives or assigns, for any loss or damage, and any claims or demand therefore, on account of injury to person or property, including death, whether caused by the negligence of TBC or otherwise, while Releasor is in, on or about any premises of TBC or using any of TBC’s facilities or equipment or participating in any program affiliated with TBC, without regard to location. This release not only constitutes a release with respect to any injury to the person or property as characterized above, but also constitutes a release on TBC’s liability for injuries resulting from TBC’s future negligence and constitutes a waiver of the Releasor’s legal rights. The undersigned expressly agrees that the foregoing Waiver of Liability is intended to be as broad and inclusive as permitted by the law of the State of Connecticut and that if any portion thereof is held invalid, the undersigned agrees that the balance shall, nevertheless, continue in full force and effect. The undersigned further understands that this waiver is applicable to all activities in which the undersigned elects to participate. The Releasor hereby specifically agrees to forever release, waive, indemnify, save and hold harmless, discharge and covenant not to sue TBC with respect to any or all liability to the Releasor, his or her representatives or assigns, for any potential Covid-19 exposure or contraction of the virus to any and all parties. The undersigned understands that video and/or photographs of participants may be taken and used for promotional purposes. The undersigned understands that the TBC has the right to dismiss any person whose actions or attitude are deemed detrimental to the TBC and/or other participants.
In the event of an emergency, I hereby give permission to Truth Baptist Church and its representatives who are with my child at the indicated event to obtain medical assistance for my child. I also give permission to the physician selected to hospitalize and secure proper treatment for my child.
During this activity, the participant may be photographed or video taped for promotional purposes.