Liability & Release

I (We) acknowledge that participation in any and all Maricopa Lutheran Church (AKA Maricopa Lutheran, MLC) programs or events is voluntary and may involve activities that require traveling or physical exertion.  We agree to the following conditions for participation of children and youth in the ministries of Maricopa Lutheran Church of Maricopa, AZ.

1. Maricopa Lutheran Church is not responsible for the loss or theft of personal belongings.
2. Misconduct may result in the transportation home of my child/youth from an activity at the parent/guardian’s expense. A participant sent home for disciplinary reasons will NOT receive a refund of any fees.
3. Participation in Maricopa Children or Youth Ministry events or programs is a privilege, this privilege may be denied by MLC staff when, in their opinion, participation of the child/youth is disruptive and not keeping with the mission of MLC.
4. I understand that my child/youth may be photographed and/or filmed and his/her image may be used in video presentations, printed publications, eBlast, or on Maricopa’s website or facebook page or other electronic media. Your child’s name will not be published.
5. I hereby take the following action for my child/youth, myself, my executors, administrators, heirs, next of kin, successors and assigns: A) I waive, release and discharge from any and all claims or liabilities for death or personal injury damages of any kind, which arise out of or relate to my child’s/youth's participation in the events and programs of Maricopa Lutheran Church, the following person, or entities: Maricopa Lutheran Church, its pastors, staff, employees, members, volunteers, chaperones, representatives, subcontractors and agents of any of the above; B) I agree to indemnify and hold harmless and not to sue any of the persons or entities mentioned above for any claims or liabilities that I have waived, released or discharged herein including all claims, judgments and costs including attorney’s fees; and C) I indemnify and hold harmless the person or entities mentioned above from any claims made or liabilities assessed against them as a result of my child’s/youth's participation in MLC’s related activities.  I hereby assume the risk of my child/youth participating in all Maricopa Lutheran Church ministry activities or programs.
6. I agree to indemnify and hold harmless the person or entities mentioned above for any claims or liabilities assessed against them as a result of any insufficiency of my legal capacity or authority to act for and on behalf of the minor in the execution of the release.
7. I hereby authorize any licensed physician, emergency medical technician, hospital or other medical or health care facility to treat the minor named herein for the purpose of attempting to treat or relieve any injury received by said minor.  I authorize any such Medical Provider to perform all procedures deemed medically advisable in attempting to treat or relieve any such injuries.  I consent to the administration of anesthesia as deemed advisable.  I realize and appreciate that there is a possibility of complications and unforeseen consequences in any medical treatment, and assume any and all such risk for and on behalf of myself and said minor.  I understand that attempts will be made to contact me in the most expeditious way possible.  Permission is also granted to Maricopa Lutheran Church representatives to provide needed emergency treatment to the child/youth prior to his/her admission to a medical facility.

I agree with the conditions detailed above and hereby grant permission for my child/youth to attend and participate in all programs or events of Maricopa Lutheran Church.