HS Hume Lake 2017



Registration Information

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Roommate Request

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Release from Liability and Authorization to Provide Treatment

I represent that I am the parent/legal guardian of the student listed above, who is under 18 years of age. I understand that every activity sponsored by Venture Christian Church is carefully planned and adequately supervised by mature adults. I acknowledge that even with the best planning and precaution, unforeseen events can occur. I assume full responsibility for my child's participation in Venture Christian Church activities, whether such risks are known or unknown to me at this time, and understand that my child is responsible for applying all instruction and rules given to him/her for any activity or incidental activity. I give my permission for him/her to take part in any activities sponsored by Venture Christian Church and permit the church to furnish any necessary transportation (within the limitations of church insurance and the law) for such activity. I assume personal responsibility for and hereby release and agree to indemnify and hold harmless Venture Christian Church, its officers, directors, employees, agents, and any parties volunteering on behalf of the church ("VCC") from all actions (including, but not limited to, personal injury, property damage, or wrongful death), costs, expenses or damages of any kind growing out of or related to any activities (on or off church grounds), transportation to and from activities, or for any liability for personal injury, property damage or wrongful death caused by or resulting from participation in such activities. I further hereby waive the provisions of Section 1542 of the Civil Code of the State of California, which provides: "A general release does not extend to claims which the creditor does not know or suspect exist in his favor at the time of executing the release, which if known by him must have materially effected his settlement with the debtor." This release shall be binding upon my heirs, representatives, successors, and assigns.

MINOR'S MEDICAL RELEASE

I will assume full responsibility for any medical costs incurred in the event of an accident or other incident requiring medical treatment and I release Venture Christian Church from any liability for such costs. In the event of an emergency in which my child is in need of immediate hospitalization, medical attention or surgery, and after reasonable efforts have been made to contact me or my spouse and we cannot be located for the purpose of consenting thereto, I hereby consent and authorize medical treatment, including but not limited to, emergency surgery or treatment, which is deemed advisable or necessary by, and is to be rendered under the general or special supervision and upon the advice of a medical professional licensed under the provisions of the Medical Practice Act of the State of California. I agree to pay any and all medical costs and other expenses associated with such treatment, including transportation costs. I understand that my medical insurance carrier may be billed for medical charges in the case of illness or injury while participating in any church sponsored activity on or off campus.

I give my permission for Venture Christian Church to take and use pictures of my child during church sponsored events.

By electronically signing and submitting this completed registration form I fully understand that I am releasing Venture Christian Church from certain forms of general and medical liability.

I, the undersigned, agree to the terms above:


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