General Liability Release & Insurance Info
In consideration for being accepted by Highland Park Community Church for participation in their Youth Ministries
Events we (I) being 18 years of age or older, do for ourselves (myself) (and for and on behalf of my child-participant if
said child is not 18 years of age or older), do hereby release, forever discharge and agree to hold harmless Highland
Park Community Church and the directors thereof from any and all liability claims or demands for personal injury, sickness
or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned
and the child-participant, that occur while said child is participating in the above-described trip or activity.
Furthermore, we (I) [and on behalf of our (my) child-participant if under the age of 18 years] hereby assume all risk
of personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities
Authorization and permission is hereby given to said church to furnish any necessary transportation, food, and
lodging for this participant.
Pictures taken by HPCC staff are property of HPCC Youth Ministries and may appear on the website or Facebook
page or other social media sites.
The undersigned further hereby agree to hold harmless and indemnify said church, its directors, employees, and
agents, for any liability sustained by said church as the result of the negligent, willful, or intentional acts of said
participant, including expenses incurred attendant thereto. This form is valid for all Highland Park Youth Ministry Events
until the release date of August 31, 2019.
(If the participant has not attained the age of 18 years):
We (I) are the parent(s) or legal guardian(s) of this participant, and hereby grant our (my) permission for him (her) to
participate fully in said trip, and hereby give our (my) permission to take said participant to a doctor or hospital and
hereby authorize medical treatment, including, but not in limitation to emergency surgery or other medical treatment,
and assume the responsibility of all medical bills, if any.
Further, should it be necessary for the participant to return home due to medical reasons, disciplinary action, or
otherwise, we (I) hereby assume all transportation costs for student and an adult chaperone of the same sex