Liability/ Medical Release Form
Please fill out this form and click submit.
I do release, forever discharge and agree to hold harmless Global Church of Georgia 600 Pio Nono Ave Macon GA, 31210, it’s directors, employees, and agents thereof from any and all liability, claims or demands from personal injury, sickness or death, as well as property damage and expenses of any nature whatsoever may occur while said person in participating in any religious activities while at Global Church GA. The undersigned further hereby agrees to hold harmless and indemnify said church, it’s directors, employees, and agents from any liability sustained by said participant, including expenses incurred attendant thereto. The undersigned further consents to the administration of first-aid and/or nurses or doctors, or any other form of medical treatment necessitated by illness or injury that may require the same. In the event of necessity of such care or treatment as heretofore described the undersigned agrees to hold harmless and indemnify said church, it’s directors, employees and agents from any acts malfeasance, and/or failure to the act on the part of those chosen to administer medical care on behalf of the participant.
Name
*
Phone
*
As participant or parent/legal guardian, I have carefully read the foregoing release, know the contents thereof, and sign the same of my own free act and deed.
*
Please select all that apply.
Yes
Submit
Description
Please fill out this form and click submit.
×
Please Fix the Following