The Participant and Volunteer application is necessary for everyone participating in a Friendship group or a Summer Friendship Gathering.  This includes all participants with disabilities, family members, caregivers, and volunteers.

CONSENT AND RELEASE OF LIABILITY

The undersigned hereby release and forever discharge Connection Ministries and the congregation(s) named on this application from any and all liabilities claims, losses and damages, as set forth herein.  I, the undersigned, the person named on this application or the duly authorized representative hereby consent to participation in all ministry events and activities of Connection Ministries and the congregation(s) named, including but not limited to Bible Studies, worship services, respite programs, retreats, and fellowship gatherings, that may include: group games, craft activities, meals or snacks, and transportation to and from such events and activities. I give my consent for a review of the applicable online sexual offender registry that is available to the public. Any negative information discovered may be confidentially released to the respective congregation, Connection Ministries’ leaders of the event or activity, and applicable governmental authorities. I hereby consent to the use of my first name, unless otherwise agreed in publications describing such events and activities, and the right to use my image, voice recordings and video recordings taken at such events and activities. Such uses may include any form of publication such as radio, television, social media and/or printed materials.  At no time will information about the named person be used for any reason other than to promote the event and ministries. At no time will addresses, emails, phone numbers, or other personal information be released without the named person’s consent for such disclosure. I release and forever discharge Connection Ministries and the congregation(s) named, their successors and assigns, as well as employees, agents, independent contractors, directors, trustees, elders, officers, from any and all losses, claims damages and causes of action at law or in equity, that the person named, or his/her authorized representative may have, as a result of participation, travel to and from such events or activities.  This Release of Liability shall include any and all present or future claims, losses and damages, demands or actions in law, or in equity that may hereafter be made or brought by me or my authorized representative as to any personal injury, illness, physical condition, inconvenience or loss sustained by the person named on this application. I understand that this consent and liability release is valid for five years.

Participant and Volunteer Application

Participant or Volunteer Information
Emergency Contact Information
Special Dietary Needs – Completed by all Applicants
Describe Applicant with Disability
Application Signature