I hereby give my consent to participate in the following activity of Covenant Youth of Alaska: In consideration of my consent to participate in this event or program, I represent and agree that:
I am aware of the hazards and risks to my person and property associated with my participation in a programs and events with Covenant Youth of Alaska, such hazards and risks including, but not limited to death or injury by accident, disease, weather conditions, inadequate medical services or supplies, criminal activity, and random acts of violence. I accept my participation with full awareness of these risks, and, subject to any insurance coverages that may be available to me from any source, and only with respect to Covenant Youth of Alaska and its agents, officers, directors, and employees, I voluntarily assume all risk of death, injury, and illness associated with such risks, and any damage to my personal property, and I release Covenant Youth of Alaska and its agents, officers, directors, and employers from any liability whatever arising as a result of death, injury, or illness that I may suffer as a result of participation in activities with Covenant Youth of Alaska.
To the fullest extent permitted by law, I release Covenant Youth of Alaska, its trustees, officers, directors, employees, agents and representatives from any injury, harm, damage or death which may occur to me while participating in the activity and agree to save and hold harmless Covenant Youth of Alaska, its trustees, officers, directors, employees, agents and representatives from any claims arising out of my in the activity.
Further, I do consent to any medical, surgical, x-ray, anesthetic, or dental treatment that may be deemed necessary for me. I understand that efforts will be made to receive consent prior to treatment but, in the event I am unable to give consent in an emergency, I give permission to the activity leader to make the decisions necessary for treatment. Should there be no activity leader available, I give permission to the attending physician to treat me.
I am not an employee of Covenant Youth of Alaska.
I attest and certify that I have no medical conditions that would prevent me from participating in programs and events at Covenant Youth of Alaska.
I attest and certify that I have major medical insurance.
I also understand that my major medical insurance will provide primary insurance coverage in the event of an injury requiring medical services for me. I further understand that it is my responsibility to determine if my major medical insurance provides adequate insurance for my needs. If I desire additional insurance, it is my responsibility to purchase that additional insurance.
I expressly waive any defense to the enforcement of any provision of this commitment arising from a claim of lack of consideration and warrant that this commitment constitutes a legal, valid, and binding obligation upon me enforceable against me in accordance with its terms.
I hearby give permission to use photos/video of me for CYAK promotions and print material.
I expressly agree that this assumption of risk agreement is intended to be a broad and inclusive as permitted by law. I further state that I HAVE CAREFULLY READ THE FOREGOING ASSUMPTION OF RISK AND UNDERSTAND ITS CONTENTS, AND I VOLUNTARILY SIGN THIS RELEASE AS MY OWN FREE ACT, THIS IS A LEGAL DOCUMENT AND I UNDERSTAND THAT I HAVE THE OPPORTUNITY TO CONSULT WITH AN ATTORNEY BEFORE SIGNING IT.
