First Name
Last name
Date of Birth
Gender MaleFemale
*Phone Number
Can we text / message this number?
(Cellular and data rates may apply)
YesNo (call only)
*Email
*Emergency Contact Name
(Must be Parent/Legal Guardian if participant is under 18)
*Emergency Phone Number
Medical Conditions
(Do you have any medical conditions event leaders should be aware of?)
(The legal stuff so you don't sue us if you sprain your ankle. Enjoy the read!)
Waiver and Release of Liability
The undersigned acknowledge and agree that the participant’s involvement in Kairos Ministries, Inc. (Tribes Minnesota and Frontline Minnesota) is voluntary and may involve activities, events, or programs that require travel and physical exertion. I acknowledge that there is inherent risk in the participant’s involvement in any activity and that I and/or the participant may suffer property damage, bodily injury, or even death. Therefore, in consideration of the participant’s involvement in Kairos Ministries, Inc. and its activities and for other sufficient good and valuable consideration, I agree to the following:
- I hereby agree and commit to the following for and on behalf of the participant, myself and any others legally responsible for the participant jointly and severally, and any of mine or the participant’s respective executors, personal representatives, administrators, trustees, heirs, guardians, conservators, next of kin, successors, and assigns:
A) I waive, release, and discharge from any and all claims, damages, injuries, or liabilities of any type of nature arising from or associated with any property damage, death, or personal injury I and/or the participant may sustain all the following persons or entities: Kairos Ministries, Inc., any of its affiliated programs or ministries, and its directors, leaders, employees, volunteers, representatives, subcontractors, and agents:
B) I agree not to sue any of the persons or entities identified in clause A above for any of the claims, damages, injuries, or liabilities that I have waived, released, or discharged herein and:
C) I indemnify and hold harmless the persons or entities identified in clause A above from any claims, damages, injuries, or liabilities that may be asserted or assessed against any of them arising from or in any way connected with the participant’s actions, failure to act, or involvement in any activity. I hereby voluntarily assume and accept all the risks of or that could occur in connection with the participant’s involvement in any Kairos Ministries, Inc. activities.
D) I further agree to indemnify and hold harmless the persons and entities identified in clause A above for any claims, damages, injuries, and liabilities referenced in this document including, without limitation, reasonable attorney’s fees of the parties I release or indemnify herein.
- I agree Kairos Ministries, Inc. is not responsible for the loss or theft of personal belongings.
- I understand that the participant’s image may be photographed or filmed and I consent to the use of the recorded images in video presentations, printed publications, website articles, and social media posts of Kairos Ministries, Inc. or any of its Ministries. I understand that Kairos Ministries, Inc. will not publish names alongside photos of individuals without prior consent; however, I acknowledge that Kairos Ministries, Inc. cannot control or assume responsibility for third-party actions, such as tagging or commenting on posts.
- I have carefully read this Waiver and Release of Liability.
- I, being of legal capacity, hereby sign this Waiver and Release from Liability and accept to make the commitments made herein for and on behalf of the participant, myself, and any respective successors and assigns as stated more fully above; and understand that I am giving away substantial legal rights.
*Participant OR Parent/Legal Guardian Signature
Parent/Legal Guardian Signature is required if participant is under 18
*Date
I understand this is a legal representation of my signature.
Media Preferences
Kairos Ministries, Inc. can not guarantee the participant will not appear in online promotional material. However, we will make an effort to respect the wishes of our participants.
I would prefer not to be shown in any online photos or video.
Permission to Contact I agree to be contacted by Kairos Ministries / Tribes MN regarding events.
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