This Release and Waiver of Liability executed on __________________ (date) for
__________________
("Student") releases BLOC Ministries, a nonprofit corporation organized and existing under the
laws
of the State of Ohio and each of its directors, officers, employees, and agents. The student
desires
to participate in BLOC Ministries Hope for the Hill program.
The parent/guardian is responsible for providing insurance coverage for the student in the
event of
injury or illness resulting from participating in BLOC Ministries' programs.
Waiver and Release: I, __________________, (parent name)
release and forever discharge and hold harmless BLOC Ministries and its successors and assigns
from
any and all liability, claims, and demands of whatever kind of nature, either in law or in
equity,
which arise or may hereafter arise from the programs of BLOC Ministries. I understand and
acknowledge that this Release discharges BLOC Ministries from any liability or claim that my
student
may have against BLOC Ministries with respect to bodily injury, personal injury, illness,
death, or
property damage that may result from participating in BLOC Ministries programs.
Insurance: Further I understand that BLOC Ministries does not assume any
responsibility for or obligation to provide my student with financial or other assistance,
including
but not limited to medical, health, or disability benefits or insurance. I expressly waive any
such
claim for compensation or liability on the part of BLOC Ministries.
Medical Treatment: I hereby Release and forever discharge BLOC Ministries
from any
claim whatsoever which arises or may hereafter arise on account of any first-aid treatment or
other
medical services rendered in connection with an emergency with my student at BLOC Ministries
programs.
Assumption of Risk: I understand that volunteering with BLOC Ministries may
include activities that may be hazardous to my student including, but not limited to involving
inherently dangerous activities. As a parent, I hereby expressly assume risk of injury or harm
to my
student from these activities and release BLOC Ministries from all liability.
Photographic Release: I grant and convey to BLOC Ministries all right,
title, and
interests in any and all photographs, images, video, or audio recordings of my student or
likeness
or voice made by BLOC Ministries in connection with my student participating in BLOC
Ministries
programs.
Other: As a parent of __________________
(name of student), I expressly agree that this Release is intended to be as broad and
inclusive as
permitted by the laws of the State of Ohio and that this Release shall be governed by and
interpreted in accordance with the laws of the State of Ohio. I agree that in the event that
any
clause or provision of this Release is deemed invalid, the enforceability of the remaining
provisions of this Release shall not be affected.
By signing below, I express my understanding and intent to enter into this Release and Waiver
of
Liability willingly and voluntarily.
