First, Tell Us About Yourself:

Parent Information

Multimedia Release: I hereby authorize Osborne Neighborhood Church, to publish photographs and videos taken of my minor child, for use on the Osborne Neighborhood Church website or publications such as YouTube, Facebook, X, newsletters, brochures, and advertisements. I acknowledge that since my child's participation is completely voluntary, neither I nor my child nor any member of my family will receive financial compensation for the use of these photographs and videos. I further agree that my child's participation and the usage of these photographs and videos confers upon me and my child no rights of ownership whatsoever. I hereby waive any right to inspect or approve the finished video and photographs or printed electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown. I hereby agree to release, defend, and hold harmless Osborne Neighborhood Church and its agents or employees, including from and against any claims, damages or liability arising from or related to the use of the photos and video, including but not limited to any misuse, distortion, blurring, alteration, optical illusion or use in composite form, either intentional or otherwise, that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution. I hereby affirm that I am the parent or legal guardian of the participating minor child listed on this form. I have read the above authorization, release and agreement, prior to its execution; I fully understand the contents thereof. This agreement shall be binding upon me and my heirs, legal representatives and assigns.

I/we understand that OSBORNE NEIGHBORHOOD CHURCH cannot protect my child/student and/or me from risks which may be encountered as a result of my child/student participating in any church sponsored programs. I/we realize there are natural, mechanical, and environmental conditions and hazards which independently or in combination with any activities engaged in while participating in this program may result in the exposure to certain risks including exposure to Coronavirus (COVID-19), or other biological agents, virus or similar bacteriological agents, and the risk of being quarantined, or illness that may result in medical care, hospitalization or death. I hereby agree not to enter the campus of OSBORNE NEIGHBORHOOD CHURCH nor permit my child/student to enter the campus of OSBORNE NEIGHBORHOOD CHURCH if they have exhibited within the previous 48 hours any symptoms currently listed by the Center for Disease Control and Prevention as Symptoms of CORONAVIRUS (see I hereby state that I, on behalf of my child/student and myself, am an adult, over the age of 18, and legally competent to sign this form. I understand these inherent risks and dangers involved with participation in the church providing their services and acknowledge the existence of risks which are not obvious or predictable, and hereby intend this release to extend to injury or loss which results from both obvious or predictable risks, as well as risks that are unpredictable and or not obvious to extend to myself and my child/student, as applicable. In consideration of myself and my child/student, I/we, and any legal representatives, heirs, and assignees, hereby release, waive, and discharge OSBORNE NEIGHBORHOOD CHURCH, its officers, directors, employees, agents, and representatives from all liability of any loss or damage, and any claim or damages resulting therefrom, on account of any injury, illness or exposure to and/or contracting the Coronavirus (COVID-19) or other biological agents, virus or similar bacteriological agents by me or my child/student’s attendance and participation in any OSBORNE NEIGHBORHOOD CHURCH program, including any medical expenses, injury and/or death. I agree to indemnify OSBORNE NEIGHBORHOOD CHURCH, its officers, directors, employees, agents, and representatives from any loss, liability, damage, or cost that may be incurred due to my child/student’s participation in the aforementioned program, whether caused by the negligence of OSBORNE NEIGHBORHOOD CHURCH or otherwise. I fully understand, on my behalf, and behalf of my child/student, the risk associated with the aforementioned participation and assume any risk associated therewith. This notice, release, and indemnity agreement contains the entire agreement between and among the parties hereto, and the terms of this release are contractual and not a mere recital. The parties to this agreement hereby agree that the interpretation and enforceability of this Release shall be governed by the laws of the State of California. I expressly agree that this release, waiver, and indemnity agreement is intended to be as broad and inclusive as permitted by applicable laws and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. I understand that by signing this agreement, I am giving up on behalf of my child/student and myself certain legal rights and remedies including the right for my child/student and/or myself to recover damages in the event of death, personal and/or bodily injury of any kind, property loss or damage, expenses of any nature whatsoever including attorney’s fees, and other losses that my student(s) or that I may sustain in association with my child/student’s participation in the program. I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW AND UNDERSTAND THE CONTENTS THEREOF. I SIGN THIS RELEASE VOLUNTARILY AS MY FREE ACT WITH FULL KNOWLEDGE OF ITS SIGNIFICANCE, INTENDING TO BE LEGALLY BOUND THEREBY.

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Tell Us About Your Participant

Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew, but we cannot promise all requests will be possible.

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