I hereby give my permission for myself or my child to participate in activities (collectively referred to hereinafter as “Event”) organized by UNITED Student Ministries and their affiliated churches and their officers, employees, agents, representatives, affiliates, and licensees (collectively referred to hereinafter as “DNOW 2024”). I hereby release, hold harmless and absolve DNOW 2024, its officers, employees, staff, sponsors, affiliates, licensees, vendors, and all others who may participate in the planning, organization, production, presentation and implementation of the Event, individually and collectively, from and against any and all responsibility and liability for any illness, injury, misadventure, harm, loss or inconvenience of any kind suffered or sustained as a result of, or in any way related to, participation in the Event.

I understand that in the event I or my child requires medical treatment while participating in the Event, reasonable efforts will be made to contact my emergency contacts designated hereinbelow; however, I hereby consent and give my permission to the DNOW 2024 staff or any adult counselor acting on behalf of DNOW 2024 with respect to the Event, to consent to an X-ray examination, medical, dental or surgical diagnosis; treatment; and hospital care advised and supervised by a physician, surgeon or dentist (as appropriate) licensed to practice under the laws of the State where the services are rendered, either as an outpatient or in any hospital. To the best of my knowledge, I have listed below all of my or my child’s medical allergies and medications currently prescribed or being taken, medical problems and other pertinent information.

Finally, I hereby authorize DNOW 2024 to record and photograph (on film, tape, digital, electronic or otherwise) me or my child and to record his or her voice during their participation in the Event. I hereby further authorize and agree to DNOW 2024 unrestricted use, reuse and distribution of said images and recordings, in whole or in part, whether in the original or modified form, in any manner or media, including, without limitation, for purposes of advertising, promoting and publicizing the Event, DNOW 2024, whether during the Event or at any time thereafter, in the sole and absolute discretion of DNOW 2024, both in the United States and internationally. I expressly and irrevocably waive any and all rights I might otherwise have, now or in the future, to any related privacy or intellectual property rights, proceeds, benefits or similar claims of any kind. I hereby release and discharge DNOW 2024 (as defined hereinabove) its officers, employees, staff, sponsors, affiliates, licensees, vendors, and all others who may participate in the planning, organization, production, presentation and implementation of the Event, individually and collectively, from and against any and all claims, demands, or causes of action that I may now or hereafter have in connection with or in any way related to the use and exercise of the rights granted in this release and consent.


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$45.00
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