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Free California Liability Release Form – Release of All Claims Form

A liability form is used as a legal document to release a party from any liability in the future. It is used to waive off any one party’s responsibility when damages of any kind occur.

California Liability Release Form 3

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Text version of this Form

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LIABILITY RELEASE FORM – Release of All Claims

In consideration for being accepted by River of Life Christian Church for participation in any church

event or otherwise occurring from January 01, 2005 and any date thereafter, we (I) being twenty-one (21)

years of age or older, do for ourselves (myself) [and for and on behalf of my child-participant if said child is

not twenty-one (21) years of age or older] do hereby release, forever discharge and agree to hold River of

Life Christian Church and the directors thereof from any and all liability, claims or demands for personal

injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be

incurred by the undersigned and the child-participant that occur while said child is participating in the above-

described trip or activity, or any trip or activity. Furthermore, we (I) [and on behalf of our (my) child-participant

if under the age of twenty-one (21) years] hereby assume all risk of personal injury, sickness, death, damage

and expense as a result of participation in any and all events, meetings, recreation and work activities

involved therein. Further, authorization and permission is hereby given to said church to furnish any

necessary transportation, food and lodging for this participant. This release covers transportation provided by

ROLCC and their representatives who are properly licensed to drive in the state of California that will be

driving the minors to ROLCC or any other site during program and activities.

The undersigned further hereby agree to hold harmless and indemnify said church, its directors,

employees and agents, for any liability sustained by said church as the result of the negligent, willful or

intentional acts of said participant, including expenses incurred attendant thereto. (If the participant has not

attained the age of 21 years): We (I) are the parent(s) or legal guardian(s) of this participant, and hereby

grant our (my) permission for him (her) to participate fully in said trip, and hereby give our (my) permission to

take said participant to a doctor or hospital and hereby authorize medical treatment, including but not in

limitation to emergency surgery or medical treatment, and assume the responsibility of all medical bills, if

any. Further, should it be necessary for the participant to return home due to medical reasons, disciplinary

action or otherwise, we (I) hereby assume all transportation costs.

____________________________________ ____________________________________

(Type or print name of participant) [Parent(s) telephone]

Hospital Insurance: ____Yes ____No

Insurance Company: ____________________________ Policy Number:_____________________

Physician’s Phone Number: _________________________

Emergency Phone Numbers: _________________________ __________________________

(Regardless of age, both parents along with participant must sign unless parents are separated or

divorced in which case the custodial parent must sign.)

____________________________________ _________________________________________

Father’s Signature Date Mother’s Signature Date

____________________________________ _________________________________________

Legal Guardian’s Signature Date Participant’s Signature Date

Participant Only – I have read the foregoing and understand the rules of conduct for participants

and will abide by them as well as the directors of the leadership of the trip, event, or activity.

____________________________________

Participant

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