Hillvue Heights Church

Jesus Prom

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TERMS AND CONDITIONS

This consent form gives permission for the staff and/or volunteers of Hillvue Heights Church and the Jesus Prom to seek medical attention whenever it's deemed necessary, and releases the Church, staff, and volunteers of any liability against personal losses of named participant. I consent for him/her to attend Jesus Prom and all activities pertaining to this event. I understand that there are inherent risks involved in any ministry, and I hereby release the Church, it's pastors, employees, agents, and volunteer workers from any and all liability for any injury, loss, or damage to person or property that may occur during the course of this participant's involvement. In the event that he/she is injured and requires the attention of a doctor, I consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by the Church, I agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I also acknowledge that we will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance provider. Further, I affirm that the health information provided above is accurate at this date and will, to the best of my knowledge, still be in force for the participant named above.

From time to time, Hillvue Heights Church records events, including audio and video recordings and photographs, in various activities at church-related functions. I understand and agree that Hillvue will own any such recordings (audio, video, photographic, electronic, and print) of the participant and authorize Hillvue to use such recordings for advertising, promoting, or providing products or services of Hillvue. I waive any claim for compensation related to Hillvue's use of recordings of this participant. I agree not to hold Hillvue and its officers, employees, and agents liable in any way arising out of or relating to the use of recordings of this participant.

I have legal custody of the participant named above, a minor, or I am of legal age to consent to these terms and conditions.

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