Zoar MB Church


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Participant Information

Household / Adult Primary Contact

Relationship to Participants: *


Zoar MB Church, requires a signature for all attendees of the church and all participants of any church activity including, but not limited to an and all church and recreational sports and activities. Furthermore, this form releases Zoar MB Church to photograph/video and to use photographs/videos of myself or my child in publication, advertising, promotional purposes, internet, and/or any visual presentations which inform people of the services and activities of the youth group or Zoar MB Church. The signature provided confirms Agreement to Attend, Participate, an Assumption of Risk and Release Form in order to participate in any Church sponsored activity. Activities may include camp, games and any other physical adventure activities that we may participate in. The sponsors and representatives of Zoar MB Church will take all reasonable precautions to ensure the safety of everyone involved in these activities.

I understand that each participant must assume the risk of injury and any financial responsibility that could result from participating in any church activity. I agree to assume such risks and responsibility. I, on my behalf and the on behalf of my heirs and assigns, hereby release, indemnify and hold harmless Zoar MB Church, staff, leadership and sponsors/volunteers from any and all claims, including bodily injury, that the named student may have been sustained in connection with participation in any and all church activities.

I understand that the staff and sponsors of the Zoar MB Church reserve the right to dismiss, without refund, any participant whose influence is detrimental to the operation of the church activity, as determined by the desertion of the church staff and/or sponsors. I understand that as a participant in Zoar MB Church youth activities I am a representative of the church and I need to conduct myself in such a manner that is always positive. If my behavior is not in accordance with such, I understand that I will be removed from the activity and my parents will be notified, and they must pick me up from the activity. The church staff and sponsors will not tolerate the use of alcohol, tobacco products and illegal drugs. If I am found to be in possession of any of these items I understand that my parents will be notified and they will be required to come and pick me up from the church activity. I have read (or have had read to me) this complete document and I understand the information contained in it. I have freely and voluntarily signed it.

Student Signature
Parent/Guardian Signature *
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