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MOUNTAINSIDE MINISTRIES ACTIVITIES--General Liability Release Form

All persons participating in Mountainside Activites need this form on file and in addition to the form for riding.

 

General Activity Conditions:

  1. By completing and Esigning this form electronically, you agree to hold Mountainside Ministries harmless from any and all liability, injury, and damages, even if it was caused by negligence, for your participation in Mountainside activities.
  2. You agree to complete this form to make use of Mountainside’s recreational facilities or off-site events such as, but not limited to, camping, day trips, or rallies.  Enrollment in Mountainside Academy requires an additional and separate copy of any and all liability release forms for inclusion in the student’s permanent records.
  3. You represent and warrant that you are at least 18 years of age and that you possess the legal right and ability to enter into this agreement.  If participation is for a minor, only a parent or legal guardian may Esign the form.  You agree to submit a separate form for each member of your family.
  4. You agree to complete and submit new liability release forms because of any revision or change in either Mountainside’s activity policy or your contact or medical information.  You agree otherwise to complete and submit annually new liability release forms  to comply with Mountainside’s general activity policy.
  5. You agree that you or your child is able to take part in any and all activities, unless you have listed exclusions on the fill-in form.  In the event that a medical urgency occurs for children, Mountainside staff will try to reach you at the telephone number you give us.  The staff may dial 911 for your child’s situation at staff’s discretion.
  6. Some information asked for may be duplicated on other forms, so please understand that sometimes staff persons carry copies of these forms and the information must be handy.
  7. You agree that activity participation at Mountainside is at your own risk and may include but is not limited to swimming; interaction with livestock, including horses; riding off-road vehicles; team sports; wagon rides; hiking in areas inhabited by wildlife; bus transportation; and riding watercraft.
  8. You agree that Mountainside may use your or your child’s likeness and voice for advertising purposes or inclusion in any multimedia creative work we may produce.
  9. You agree that before admission as a volunteer into any activity, program, or department promoted by Mountainside a criminal background screen is required at your expense.

Here is a copy of this agreement for you to keep.

Fields marked with * are required.
Last Name of Participant*
First Name of Participant*
Sex*
Male
Female
Who is the Participant?*
Myself and I am at least 18 years of age
My child and I am the parent or legal guardian
If Participant is a child, what is the date of birth?*
Street Address*
City, Zip*
Emergency Phone Number*
Other Phone Number
Special instructions or medical needs and allergies; or type none*
Purpose of this Form*
Youth Snow Camp March 5-7, 2010
Youth Sleepover March 27, 2010
Youth Group hosts pool party for Las Brisas May 22, 2010
Youth Survivor Campout May 29th
General Activities (Pool/Initial Form)
General Activities (Annual Renewal)
General Activities (Information Change)
If this form is being completed for your child and you do not want him/her to participate in any activities, please explain here or type none*
If this form is being completed for a child, what is your relationship?*
Parent
Legal Guardian
This form is for myself (at least 18 years of age)
Your email address*
Myself or my child is able to participate in any and all of these activities, unless I have listed exclusions on the fill-in form. In the event of that an emergency occurs for my child, I give Mountainside Ministries consent to seek medical attention. I expressly agree that this release agreement is intended to be broad and inclusive as permitted by the law of the State of California and that if any portion hereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto. I state that I HAVE CAREFULLY READ AND UNDERSTAND THIS FORM; KNOW THE CONTENTS; AND ESIGN THIS RELEASE AS MY OWN FREE ACT. I understand that this is a legally binding agreement.
I do not agree. (Form will not be valid and you may not participate in Mountainside activities.)
Type Name of Person eSigning this Form*
By clicking the eSign button, I agree with the GENERAL ACTIVITY CONDITIONS (Rev 9/11/09) and that I am signing this form for myself or my minor child.
I do not agree. (Form will not be valid and you may not participate in Mountainside activities.)
Type Initials of Person eSigning this Form*
Type in text you see

This General Activities Liability Release Form is in a testing phase and may be changed or discontinued at any time.  Completion is not a guarantee of access to Mountainside facilities or any recreational event.

 

 

  

Mountainside Ministries is an interdenominational Christian church located in Southern California.

We serve the valley communities in Western Riverside County and the Inland Empire of Lake Elsinore,

Murrieta, Temecula, Canyon Lake, Wildomar, Corona, Perris, Winchester, Menifee, and Sun City.

 ©2008 Mountainside Ministries

30515 Ortega Hwy, Lake Elsinore, CA 92530 (951) 678-9402