Youth Golf Camp

OTHER INFORMATION:

Would you (or your spouse, if applicable) be interested in helping with the camp? *

Yes

Special Instructions (allergies, physical limitations, days you will miss, etc.):

Release of Liability Notice:

Crossroads Community Church does not provide health insurance coverage for participants in athletic activities at the church.

As legal guardian of this registrant, I understand and hereby agree to assume all of the risks which may be encountered on the Crossroads Community Church Youth Golf Camp, including activities preliminary and subsequent thereto. I do hereby agree to hold Crossroads Community Church, its employees and volunteers, harmless from any and all liability, actions, causes of actions, claims, expenses, and damages on account of injury to my child, to me, or to my property, even injury resulting in death, which I now have or which may arise in the future in connection with the 2012 Crossroads Community Church Youth Golf Camp or participation in any other associated activities. In the event my child becomes injured or ill during any game or activity, I authorize the coach(es) or a representative of Crossroads Community Church to secure first aid and/or the services of a physician or hospital and agree to assume all financial obligations incurred therewith.  I further release the coach(es) and all representatives of Crossroads Community Church from any liability, actions, causes of actions, claims, expenses, and damages with respect to the securing, or the failure to secure, such first aid or medical services in the event of my child's injury.

I also acknowledge that this camp will take place at Plum Creek Golf Course and not on the property of Crossroads Community Church.

I agree to the above Release of Liability Notice *

I agree to the above Release of Liability Notice

Photo/Video Release:

The Sports & Recreation Ministry at Crossroads obtains photos and/or video from each ministry activity for potential use on the Crossroads Community Church website, in photo/video albums on the ministry Facebook page, or in marketing materials for future ministry activities.  We want to be sensitive to individual desires for identity privacy.  If you do NOT want us to utilize photos or video of your child, in any way, please check the box below.

Photo/Video Release

No, I do not give permission to use my child's picture in any way, as described in the above Photo/Video Release.

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