FORMS | Minor Consent & Release

CONSENT AND RELEASE FOR A MINOR TO PARTICIPATE IN CHURCH PROGRAMS

This document contains IMPORTANT INFORMATION.
Please READ IT CAREFULLY before agreeing to the terms and conditions!

A.) RELEASE OF LIABILITY & HOLD HARMLESS

As the parent and/or legal guardian of the above named minor, I authorize and grant permission for them to attend and fully participate in ministries, programs and activities, regardless of location, (collectively, the “Programs”) that are conducted, organized or sponsored by Manchester United Methodist Church of Manchester, Missouri “MUMC”, together with any affiliated organizations, I hereby RELEASE, WAIVE, FOREVER DISCHARGE AND AGREE TO HOLD HARMLESS, “MUMC”, its clergy, leaders, directors, trustees, employees, caregivers, volunteers, members, fellow participants, and their collective representatives, successors, assigns, and heirs, as well as United Methodist Agencies, Districts, Conferences and related organizations and the leaders, directors, trustees, and employees thereof (collectively, the “Church”), from ANY AND ALL LIABILITY, LOSSES, DAMAGES TO PERSONS OR PROPERTY, DEMANDS, OR CLAIMS OF ANY TYPE WHATSOEVER, (collectively, “Claims”) arising out of, or in any way relating to, the minor's participation in “Programs”. To the fullest extent permitted by law, this includes, but is not limited to, any and all “Claims” involving PERSONAL INJURY, ILLNESS, INFECTION, OR DEATH, as well as any “Claims” proven to be the result of NEGLIGENCE BY THE CHURCH, ITS REPRESENTATIVES, CONTRACTORS, OR THIRD-PARTY SERVICE PROVIDERS.

Notwithstanding anything to the contrary, the foregoing limitations shall NOT APPLY to any “Claims” proven in a court of competent jurisdiction to be the direct and primary consequence of gross negligence or willful misconduct by the “Church” or its authorized representatives acting in their official capacity.

I agree to INFORM THE "CHURCH" in writing of any medical condition(s) which may affect the minor's participation in "Programs". This includes, but is not limited to, any allergies, pre-existing health conditions, limitations, required medications, etc.

I acknowledge that “Programs” involve KNOWN and UNKNOWN RISKS, and some activities may include strenuous or moderately strenuous physical activities or involve hazardous conditions, machinery, or equipment. I also acknowledge that the minor may be EXPOSED TO or CONTRACT an infection or other illness, including but not limited to, COVID, Influenza, RSV, etc. while engaged in “Programs.” Evidence has shown that certain infections can cause serious and potentially life-threatening illness and even death. I choose to ACCEPT THIS RISK in order for the minor to participate in “Programs” and hereby forever RELEASE AND WAIVE THE RIGHT to bring any type of "Claim" against the “Church” in connection with any illness,  infection, or injury arising out of the minor's participation in "Programs".

B.) INDEMNIFICATION

To the fullest extent permitted by law, I agree to INDEMNIFY  the “Church” and its representatives from and against any and all liability, losses or damages to persons or property, governmental charges or fines, penalties, costs (including reasonable attorney’s fees), as a result of claims, demands, or judgements, in any way arising out of the MINOR'S PARTICIPATION in “Church” programs. This includes, but is not limited to, any claims against the "Church" and its representatives arising from negligence or misconduct by the minor.

C.) CONSENT FOR TRANSPORTATION

I authorize the minor to be a passenger in any legally licensed and insured vehicle driven by an ADULT with a valid driver's license. I understand that the minor will be required to wear their seat belt, if one is available.

D.) RETURN HOME POLICY

Should I or “Church” representatives determine that it is necessary for the minor to return home from a “Program” due to medical or other reasons, the "Church" and its representatives shall bear NO RESPONSIBLITY for the minor's transportation costs. In this situation, I also understand that I will NOT be entitled to a refund of registration, participation or any other fees or funds related to the minor's participation in the “Program”.

E.) CONSENT FOR EMERGENCY MEDICAL TRANSPORTATION, FIRST AID & LIFE-SAVING MEASURES

While the minor is participating in a "Program", I authorize “Church” representatives to arrange transportation, including by emergency vehicles, of the minor to a medical or dental facility for emergency care as well as non-life threatening conditions that may benefit from treatment. Such conditions may include, but are not limited to, cuts, burns, rashes, fevers, sprains, breaks, vomiting, tooth pain, respiratory distress, injury, etc. I also authorize "Church" representatives to consent to treatment of this minor by medical and dental professionals and I agree to be liable for ANY AND ALL COSTS incurred in connection with the minor's transportation and treatments. I further grant “Church” representatives permission to release medical and other relevant information about the minor to first responders, medical personnel, adult chaperones, and "Church" leaders.

In addition, I authorize the “Church” to administer first aid and life-saving measures to the minor during “Programs” before professional emergency personnel arrive and to assist such emergency responders as requested. "Church" representatives shall NOT BE LIABLE for any civil damages, or other "Claims", for acts or omissions, EXCEPT damages occasioned by gross negligence or by willful acts or omissions in rendering emergency care.

F.) EMERGENCY CONTACTS

In case of an emergency during a “Program,” I authorize “Church” representatives to notify the adult emergency contacts designated below as soon as they determine it is safe and reasonably possible to do so.

G.) DISPUTES

I agree that any disputes arising from this Consent and Release shall be governed by the laws of the State of Missouri and will be the exclusive jurisdiction of the courts of St. Louis County, Missouri. If any provision of this Consent and Release shall be declared by any court of competent jurisdiction to be illegal, void, or unenforceable, I agree that the other provisions shall not be affected but shall remain in full force and effect.

H.) CERTIFICATION, AGREEMENT & SIGNATURE

This Consent and Release has been digitally signed by:

Please direct any future correspondence regarding this Consent and Release agreement to:

Manchester UMC
Attn: Executive Pastor
129 Woods Mill Road
Manchester, Missouri 63011