This event is for children ages 3-11
I hereby give my approval for my child’s participation in any and all activities prepared by Legacy Church of God during the selected VBX. In exchange for the acceptance of said child’s candidacy by Legacy Church of God ., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Legacy Church of God . and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected VBX sessions. In case of injury to said child, I hereby waive all claims against Legacy Church of God. including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.
As Parent and/or Guardian of the named child, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named child. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me. Permission is also granted to the Legacy Church of God and its affiliates including Directors and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility. Release authorized on the dates and/or duration of the krusade. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.
(1) My child's picture - including photographic, motion picture, and electronic (video) images.
(2) My child's voice - including sound and video recordings.
I hereby grant Legacy Church of God, its subsidiaries, licensees, successors and assigns, the right to use, publish, and reproduce, for all purpose, my childs name and pictures in film or electronic (video) form, sound and video recordings of voice, and printed and electronic copy of the information described in sections (1) and (2) above in any and all media including, without limitation, the internet and for exhibition, and other print media.
The permission extends to all languages, media and formats now known and hereafter devised. This permission shall continue forever unless I revoke the permission in writing. I further grant Legacy Church of God all right, title, and interest that that I may have in all finished pictures, reproductions, and copies of the original print, and further grant Legacy Church of God the right to give, sell, transfer, and exhibit the print in copies or facsimiles thereof, for marketing, communications, or advertising purposes, as it deems fit.
I hereby waive the right to receive any payment for signing this release and waive the right to receive any payment for Legacy Church of God's use of any of the material described above for any of the purposes authorized by this release. I also waive any right to inspect or approve finished photographs, audio, video, multimedia or advertising recordings, copy or printed matter, computer-generated scanned images, and other electronic media that may be used in conjunction therewith or to approve the eventual use that it might be applied.
By signing below, I agree that my electronic signature is the legal equivalent of a manual 'wet' signature and carries the same binding force and effect.
