Medical Release Form

1 General Release/Hold Harmless Agreement
2 Student Ministry Medical Release
  • The undersigned or a member of the immediate family of the undersigned desires to participate in various programs, events, or activities (herein collectively referred to as "Activities") operated or sponsored by Journey Christian Church. The undersigned or a member of the immediate family of the undersigned further understands and acknowledges that the undersigned or a member of the immediate family of the undersigned may incur injury or bodily damage while participating in such Activities.

    The undersigned or a member of the immediate family of the undersigned further understands and acknowledges that Journey Christian Church will not allow the undersigned or a member of the immediate family of the undersigned to participate in such Activities without releasing and holding harmless Journey Christian Church.

    Further, the undersigned or a member of the immediate family of the undersigned requests Journey Christian Church to allow them to participate in activities and in consideration thereof agree to hereby release and forever discharge Journey Christian Church, their officers and their directors and their employees, their agents and any parties volunteering on behalf of Journey Christian Church, from all actions, claims, costs, expenses or damages of any kind growing out of or related to any activity of Journey Christian Church in which the undersigned or a member of the immediate family of the undersigned participates.

    The undersigned or a member of the immediate family of the undersigned further acknowledges that this is a full and complete release for all injuries and damages which the undersigned or a member of the immediate family of the undersigned may sustain as a result of the undersigned or a member of the immediate family of the undersigned's participation in any Journey Christian Church program.

  • Use your mouse (or your touch screen if you are on a tablet) to sign your name in the box below.
  • Date Format: MM slash DD slash YYYY