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Media Permission - FOR VOLUNTEERS UNDER 18

Do you give permission to the Presbyterian Church of Novato (PCN) to use video and photographic images of your child participating in the PCN youth programs?  Any such images will become the property of PCN and can be used without compensation.  No child will be identified by name or location.  Select *ONE* of the checkboxes below.  


In consideration for being accepted by Presbyterian Church of Novato (PCN) for participation in any event administratively organized by PCN or any of its officers, directors, employees, and agents, during June 1, 2018 through May 31, 2019, we (I), being 18 years of age or older, do for ourselves (myself) [and for and on behalf of my child-participant if said child is not 18 years of age or older] do hereby release, forever discharge and agree to hold harmless PCN and its officers, directors, employees, and agents from any and all manner of suit, sickness or death, as well as property damage and expenses, of any nature whatsoever, which may be incurred by the undersigned and the child-participant while the said child-participant is participating in any event administratively organized by PCN or any of its officers, directors, employees, and agents.

Furthermore, we (I) recognize that the conditions in some of the places to which said participant will be traveling are not of the same standards as the conditions to which we (I) are (am) accustomed. We (I) recognize further that there are certain health risks as well as other risks to participants and their property. Therefore, we (I) [and on behalf of our (my) child-participant if under the age of 18 years] hereby assume all risk of personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved herein.

Further, authorization and permission is hereby given to PCN to furnish any necessary transportation, food, and lodging for said participant.  The undersigned further hereby agree to hold harmless and indemnify PCN, its officers, directors, employees, and agents, for any liability sustained by PCN as a result of the negligent, willful or intentional acts of said participant, including expenses incurred attendant there to.

We (I) understand that the document constitutes a full and complete waiver of all possible claims, including, but in no way limited to, claims for negligence in personal or property damages arising out of said participant’s involvement in any event administratively organized by PCN or any of its officers, directors, employees, and agents. No provision of this document shall, in any way, limit my right to make claims against persons other than PCN, its officers, employees and agents.

[If the participant has not attained the age of 18 years]:  We (I) are the parents(s) or legal guardian(s) of this participant, and hereby grant our (my) permission for him/her to participate fully in said trip/activity, and hereby give our (my) permission to take said participant to a doctor or hospital and hereby authorize medical treatment, including but not in limitation to emergency surgery or medical treatment, and assume the responsibility of all medical bills, if any. We (I) understand that a conscientious effort must be made to notify one of the parents or legal guardians listed below before such action is taken. Further, should it be necessary for the participant to return home due to medical reasons, disciplinary action or otherwise, we (I) hereby assume all transportation costs.

This authorization is given pursuant to the provisions of § 25.8 of the Civil Code of California.

All volunteers must complete this form.  If you are under 18 years old, a parent must complete the form and agree to the terms of the Media Release and Liability Release.   Note:  You can choose more than one Volunteer Position by clicking on multiple job descriptions.


The Following Information Needs To Be Completed If The Volunteer Is UNDER THE AGE OF 18.

By checking the box you will be emailed your digital Friends With God Kids Activity Pack.

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