Please fill in contact information for (you) the Parent / Guardian, as well as your spouse. Do note whomever this is will be the one giving consent for the family / group at the bottom of form.

Please Enter the Names and Age of ALL Children / Guests with you.
(First & Last Name, seperated by commas)

This will be all Children / Guests not listed in Parent / Guardian Section.

Please provide a list of any allergies your child may have, and specify if it is mild or severe (life threatening in nature). Write N/A if none exist.

(Optional)

Please Enter the Name and Contact Number of an Emergency Contact.

Name (First & Last), Phone Number

Please take a moment and answer these short questions to help us get to know you and your family / guests.

CHRISTIAN LIFE LUBBOCK / CHRISTIAN LIFE ASSEMBLIES OF GOD (CLL / CLAG)
GENERAL LIABILITY WAIVER & RELEASE OF CLAIMS

This Liability Waiver and Release of Claims (“Agreement”) is entered into by the undersigned participant and/or parent or legal guardian (if the participant is a minor) in favor of Christian Life Lubbock / Christian Life Assemblies of God (“CLL” or “CLAG”), a Texas nonprofit religious organization, and its pastors, officers, directors, employees, volunteers, representatives, agents, successors, assigns, and any partnering organizations, ministries, or venues (collectively, the “Released Parties”).

1. ASSUMPTION OF RISK

I understand that participation in any church-sponsored event, program, trip, camp, outing, or activity (collectively, “Activities”) organized, hosted, or sponsored by CLL/CLAG, whether held on church property or at an off-site location, involves inherent risks and hazards.
These may include, but are not limited to, personal injury, illness (including COVID-19 and other communicable diseases), property damage, theft, emotional distress, or even death.

I freely and voluntarily assume all risks associated with these Activities, whether foreseeable or unforeseeable, and whether arising from the negligence of the Released Parties or otherwise.

2. WAIVER AND RELEASE OF LIABILITY

To the fullest extent permitted by Texas law, I, on behalf of myself, my spouse, my child(ren), heirs, assigns, executors, administrators, and personal representatives, hereby release, waive, discharge, and covenant not to sue the Released Parties for any and all claims, demands, actions, damages, losses, or liabilities of any kind, arising from or related to participation in Activities — even if caused in whole or in part by the negligence, acts, or omissions of the Released Parties.

This waiver is intended to be as broad and inclusive as permitted by Texas law. If any portion is found invalid, the remaining provisions shall remain in effect.

3. COVID-19 AND COMMUNICABLE DISEASES

I acknowledge the contagious nature of COVID-19 and other illnesses and voluntarily assume the risk that I or my child(ren) may be exposed to or infected while attending or participating in CLL/CLAG Activities.
I accept full responsibility for any resulting illness, injury, or loss, and agree to hold the Released Parties harmless as stated above.

4. TRANSPORTATION & OFF-SITE EVENTS

I understand that Activities may include transportation provided by CLL/CLAG, its volunteers, or third-party providers.
I accept the risks of travel and release the Released Parties from any claims related to transportation, including accidents, injuries, or delays.

5. MEDICAL TREATMENT AUTHORIZATION

In the event of an emergency, I authorize CLL/CLAG and its representatives to obtain medical treatment for myself or my child(ren) as deemed necessary.
I agree to assume full responsibility for all resulting medical or transportation expenses.

6. PERSONAL PROPERTY

I understand that CLL/CLAG and the Released Parties are not responsible for lost, stolen, or damaged personal property.

7. PHOTO & MEDIA RELEASE

I grant CLL/CLAG permission to photograph and/or record myself and/or my child(ren) during Activities and to use such media for church-related purposes, including publications, websites, and social media.
No compensation will be provided.
(If you do not consent to media use, please notify CLL/CLAG staff in writing.)

8. PARENT/GUARDIAN ACKNOWLEDGMENT (if applicable)

If I am signing on behalf of a minor, I confirm that I am the parent or legal guardian and have the legal authority to consent on their behalf.
I understand that Texas law generally does not allow a parent to waive a minor’s own rights, but this Agreement does waive my own rights to bring any claims related to or arising from my child’s participation.

9. GOVERNING LAW

This Agreement shall be governed by the laws of the State of Texas. Any disputes shall be resolved in Lubbock County, Texas.
If any provision is held invalid, the remainder shall remain enforceable.

10. ACKNOWLEDGMENT OF AGREEMENT

By checking the box below, I affirm that I have read and understood this Agreement and voluntarily agree to its terms.
I understand that by checking this box, I am waiving substantial legal rights, including the right to sue the Released Parties for ordinary negligence.
This waiver applies to all current and future Activities sponsored by CLL/CLAG unless revoked in writing.