In checking YES, I AGREE on this document, I hereby certify that ALL of the enclosed information is correct. In the event that I can not be reached, I hereby give permission to the physician selected by the BELAY YOUTH MINISTRY staff to obtain proper medical diagnosis, hospitalize, secure proper treatment for and to order injection, anesthesia or surgery for my child as named above. I also acknowledge I have read, understand and accept the terms listed below: RELEASE OF LIABILITY the PARTICIPANT, their PARENTS, GUARDIAN, HEIRS, ASSIGNS AND REPRESENTATIVES HEREBY RELEASE Belay Youth Ministry, its staff members, volunteers, agents and representatives of any and all liability for loss injury or property damage which may be the result of any aspect of any mission trip, retreat, event, excursion, or regular programming/classes/meetings including transportation to/from these activities. The Participant may participate in activities as mentioned above located both on and off Intersection Ministries Property for the duration of this release. The Participant and the Participant's Parent(s) and or Guardian(s) understand, acknowledge, and accept that there are inherent risks, both known and unknown, in travel and in the activities in which the participant will engage in during the mission trip, retreat, event, excursion, or regular programming/classes/meetings. The Participant and the Participant's Parent(s) and or Guardian(s) also understand and acknowledge and accept that these risks may result in serious injury and or death. The Participant and the Participants Parent(s) and or Guardian(s) also understand and acknowledge and accept that the individual Participant(s) are not covered under any policy of insurance held by Belay Youth Ministry, and Participant(s) must provide any and all insurance coverage for themselves, including but not limited to health, life, and liability insurance. Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19 the novel coronavirus, COVID 19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. BELAY YOUTH MINISTRY (Belay) has put in place preventative measures to reduce the spread of COVID-19; however, BELAY YOUTH MINISTRY cannot guarantee that you will not become infected with COVID-19. Further, participation could increase your risk of contracting COVID-19. READ CAREFULLY BEFORE SIGNING. By signing this agreement, I acknowledge the contagious nature of COVID -19 and voluntarily assume the risk that I may be exposed to, or infected by COVID-19 by participation; and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to, or infected by COVID-19 at BELAY YOUTH MINISTRY may result from the actions, omissions, or negligence of myself and others, including, but not limited to, BELAY YOUTH MINISTRY employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my participation at BELAY YOUTH MINISTRY. On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless BELAY YOUTH MINISTRY, its employees, agents and representatives, of and from the claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions or negligence of BELAY YOUTH MINISTRY, its employees, agent, omissions, or negligence of BELAY YOUTH MINISTRY, its employees, agents and representatives, whether a COVID-19 infection occurs before, during or after participation at BELAY YOUTH MINISTRY. I represent that I have adequate insurance to cover any injury or illness I may suffer or cause while participating in tis activity, or else I agree to bear the costs of such injury or illness myself. I further represent that have no medical or physical condition which could interfere with my safety in this activity, or else I am willing to assume -- and bear the costs of -- all such risks that may be created, directly or indirectly, by any such condition. In the event that I file a lawsuit, I agree to do so in the state where BELAY YOUTH MINISTRY is located, and I further agree that the substantive law of that state apply. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. By signing this document, I agree that if I am exposed or infected by COVID-19 during my participation in this activity, them I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim for negligence. I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to signing. Also, I understand that this activity might not be made available to me of that the cost to engage in this activity would be significantly greater if I were to choose not to sign this release, and agree that the opportunity to participate at the stated cost in return for the execution of this release is a reasonable bargain. I have read and understood this document and I agree to be bound by its terms. If I have signed a separate general waiver of liability connected to my participation at BELAY YOUTH MINISTRY, I agree that the terms of that waiver are wholly incorporated into this document and that the terms of this document are incorporated into the separate general waiver. Photographs or videos may be taken during the experience of the mission trip, retreat, event, excursion, or regular programming/classes/meetings you or your child will be participating in. By signing this form, you are authorizing BELAY YOUTH MINISTRY to use those videos and/or photographs in any manner deemed appropriate by BELAY YOUTH MINISTRY, including but not limited to use in promotional materials or church services. This release is valid from September 1, 2021, to September 1, 2022. I have read, and understand and accept the terms above.