Under 18 Release

Student Participant for 2019-2020

FIRST PRESBYTERIAN CHURCH OF BOULDER

CONSENT FOR MINOR FOR PARTICIPATION, RELEASE AND INDEMNIFICATION, INSURANCE CERTIFICATION AND MEDIA RELEASE

1. Introduction

First Presbyterian Church of Boulder ("First Pres") is an organization that conducts numerous activities for young people. Adult volunteers and First Pres employees, agents, officers and volunteer workers lead these activities. THESE ACTIVITIES INVOLVE RISK. First Pres has a limited budget that is funded by donations from its members and friends. First Pres cannot practically conduct these activities unless it is released from, and indemnified against, claims for bodily injury or death to a participant arising from negligence on the part of First Pres or its employees, agents, officers or volunteer workers (the “Released and Indemnified Parties”). Before a Student Participant under 18 years of age is allowed to participate in any of its activities, the parents (or single parent with custody) or guardian of the minor Student Participant is required to consent to the activity and indemnify and hold harmless First Pres and the Released and Indemnified Parties against claims for bodily injury or death to the minor Student Participant arising out of the negligence of First Pres or the Released and Indemnified Parties. This release and indemnification do not apply to intentional infliction of injury of any type or injury arising out of gross negligence of First Pres or the Released and Indemnified Parties, or to any sort of sexual misconduct committed by First Pres or the Released and Indemnified Parties. Furthermore, before a minor Student Participant is allowed to participate in these activities, First Pres requires certain additional consents and assurance that the minor Student Participant is currently covered by medical insurance. For purposes of this Agreement, a "minor" is any person who has not reached 18 years of age. Should the “minor” turn 18 during the Academic Year for which this form is in effect, this form will remain valid through the end of the Academic Year for which the form was signed.

2. Nature of Activities in Which the Minor Student Participant Will Participate

The minor Student Participant named herein the online registration will participate in activities throughout the academic year noted above that are sponsored by First Pres, including, but not limited to, camps, mission trips, overnights, retreats, and other similar events and activities.

3. Age Certification; Consent to Participation

The person or persons, being the parents (or a single parent with custody) or guardian of the minor named herein the online registration, hereby represent and warrant that the minor Student Participant named herein has not reached 18 years of age, and consent to the participation of the minor Student Participant in any of the activities referred to in Paragraph 2 above.

 

4. Release from Liability

The person or persons, on behalf of themselves and the minor Student Participant named herein the online registration, release First Pres and the Released and Indemnified Parties from any claim for bodily injury or death of the minor Student Participant arising out of or related to negligence of First Pres or the Released and Indemnified Parties in connection with or related to any activity referred to in Paragraph 2 above. This release does not apply to intentional infliction of injury of any type, injury arising out of the gross negligence of First Pres or the Released and Indemnified Parties, or any sort of sexual misconduct committed by First Pres or the Released and Indemnified Parties.

5. Indemnification and Hold Harmless

THE UNDERSIGNED PERSON OR PERSONS, ON BEHALF OF THEMSELVES AND THE MINOR STUDENT PARTICIPANT NAMED HEREIN THE ONLINE REGISTRATION, HEREBY INDEMNIFY AND HOLD HARMLESS FIRST PRES AND THE RELEASED AND INDEMNIFIED PARTIES FROM AND AGAINST ANY LOSS, LIABILITY, CLAIM OR EXPENSE, INCLUDING ATTORNEYS' FEES, FOR BODILY INJURY OR DEATH TO THE MINOR STUDENT PARTICIPANT NAMED HEREIN THE ONLINE REGISTRATION ARISING OUT OF NEGLIGENCE OF FIRST PRES OR THE RELEASED AND INDEMNIFIED PARTIES.

6. Medical Insurance Certification

The undersigned person or persons hereby represent and warrant that the minor Student Participant named herein the online registration is currently covered by medical insurance which applies (except for deductibles) to injuries arising out of the activities referred to in Paragraph 2 above.

7. Arbitration and Savings Clause

Any dispute concerning the meaning or effect of this Agreement, or any action to enforce this Agreement, will be resolved by arbitration before the Judicial Arbiter Group sitting in Denver, Colorado. Should any provision in this Agreement be deemed unenforceable, then all other provisions will continue to be given full force and effect.

8. Consent for Media Coverage of Minor Student Participant

There will be times during the academic year when First Pres, its employees, agents, officers or volunteer workers will cover activities at its various camps and events with articles, video or still photography that may be published locally, nationally or on the World Wide Web. In addition, affiliates or partnering organizations of First Pres may want to include articles about First Pres activities, video or photography in their own publications or on their own web sites. The undersigned person on behalf of themself and the minor Student Participant hereby permit the minor Student Participant named herein to be included in media coverage by First Pres or affiliates of partnering organizations of Firest Pres.

 

9. Electronic Signature

By checking the box above, you, the parent or legal guardian of the minor Student Participant named herein the online registration, confirm the truth of all requested information contained in the online registration and acknowledge your acceptance of the terms of this Agreement.

Sunday Worship: 8, 9:15 & 10:45am

303.402.6400

questions@fpcboulder.org

1820 15th Street

Boulder, Colorado 80302

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