Authorization and Consent
I understand that my personal insurance will be primary for accidents and that Youth for Christ’s insurance is secondary. Youth for Christ’s policy does not cover illnesses. If you have questions, please contact Youth for Christ Insurance Department at (303) 843-6790.
Youth for Christ reserves the right to subrogation if it is later determined that personal medical insurance was in place.
This health history is correct as far as I know, and the person herein described has permission to engage in all event activities.
AUTHORIZATION FOR TREATMENT: I hereby give permission to the medical personal selected by the event director to order X-rays, routine tests, treatment, to maintain and/or release any medical records necessary for insurance purposes and to provide or arrange necessary related transportation for me or my child. In the event I cannot be reached in an emergency, I hereby give permission to the licensed medical provider selected by the event director to secure and administer treatment, including hospitalization, for the person named above.
As my attendance at a Youth for Christ event is a privilege, I release Youth for Christ, including its trustees, employees and agents, from my physical injury, including death, or illness while at event, including my Youth for Christ sponsored travel to and from event, in consideration of this privilege. I recognize and understand that there are inherent risks associated with many event activities. I will assume the risk associated therewith, whether known or unknown to me at this time. This release is also intended to include all claims of my family, estate, heirs, personal representative or assigns.
If I am under the age 18, my parent or guardian, by signing below, also consents to my release and he or she agrees that this release shall be binding upon him or her as my parent or guardian as to me and my estate, heirs, personal representative or assigns. My parent or guardian also promises, by signing below to defend, indemnify and hold Youth for Christ harmless from any claim asserted by me against Youth for Christ, including its trustees, employees and agents, if I should repudiate this release after obtaining adulthood.
I release all rights of any video, photo or other media source materials taken of my child for the exclusive use of Youth for Christ.