I/We the parent(s) on behalf of the our child for whom I (we) are legally responsible, accept the conditions and risks outlined in this waiver and release and consent to his/her participation in the activities that are a part of VBS sponsored by First Reformed Church. I represent and agree that: 1. I am legally responsible for the above minor or ward who is a voluntary participant in the activities and not an employee, agent or contractor of the Church. 2. I understand that this release is valid from July 12-15, 2021 and covers all of the activities provided to the participant by the church during this time. 3. I am aware that the information on this form may be used by the leadership of First Reformed Church. 4. In consideration of the participant being permitted to participate in the activities conducted by the church, I hereby assume all responsibility for and waive, release and discharge the Church, it's members, ministers (both ordained and lay persons), officers, agents, employees, volunteers, contractors and other associates and representatives from any and all liability and claims of any kind whatsoever, for death, personal injury, loss of property or property damage the participate or I may have, or that may subsequently accrue to participant or me, or to the respective heirs, executors, administrators or assigns as a result of participants involvement in the activities. I am aware of the potential hazards and risks to participant associated with the activities such as hazards and risks including, but not limited to, injury or death by accident, weather conditions, and random acts of violence. I accept these risks on behalf of participant with full awareness of these risks and knowing the only source of insurance available to participating or me must be provided by me, and participant and I are not relying on any insurance to be provided by the church. Furthermore, I assume full responsibility for all medical bills, damages, or other losses of any kind associated with any bodily injury, death, or properly damage while participant is taking part in the activities. 5. In addition to the above release, I further indemnify and hold the church harmless from any and all personal injury, death, loss of property or property damage, or any other damages, relating to and arising from participants activity in the activities. 6. I attest and certify that participant has no known medical, physical, psychological or emotional conditions that would prevent him or her from participating in the activities, except as stated on this form. 7. I authorize the church, its representatives, and all attending health care professionals (including but not limited to registered nurses, licensed practicing nurses, physicians/ assistants, doctors and paramedics) to provide medical treatment, to hospitalize, anesthetize, or perform surgery on Participant as required. I do release, acquit, discharge and covenant to hold harmless the church and its representatives from all actions, damages or liabilities arising out of the treatment of any illness, injury, or accident incurred during the activities. The church and it's representatives will incur no liability whatsoever while attempting to meet all medical needs participant may require during the activities. I agree to be responsible for all medical costs associated therewith. 8. I expressly agree that this release and waiver is intended to be as broad and inclusive as permitted by the laws of the State of Iowa and that I intend this waiver and release will be binding on me, participant, our family, estate, heirs, successors, assigns, insurers, medical providers, and personal representatives. If any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.