CHRIST IN YOUTH (CIY) WAIVER

Disciplinary Release and Event Administration I, the Participant, or the parent or legal guardian of the Participant if the Participant is under the age of 18, certify that Participant has full approval to take part in the Christ In Youth Program. The Participant understands that all individuals participating in Christ In Youth Events are required to abide by the Event rules, as well as rules and directions of the adult leaders and the church with whom the Participant’s group is affiliated. I understand that the Christ In Youth Program Director possesses ultimate authority over discipline during the Program, though the Program Director may delegate such authority to other individual(s), including but not limited to the minister or adult leader(s) from the church the Participant is attending the Event with, as appropriate and in the Program Director’s sole discretion. The Program Director (or designee) retains sole discretion to require a Participant to leave the Event because of misconduct or disobedience. In such instance, the Participant, or the Participant’s parent or guardian if under the age of 18, will assume full responsibility for returning the Participant home prior to the completion of the Program. Further, I acknowledge and understand that for Events that include overnight accommodations, Christ In Youth assimilates attendees based on their biological sex as indicated on the Participant’s birth certificate. Release of Liability, Indemnity, and Assumption of Risk I hereby release and forever discharge a) Christ In Youth and its directors, officers, employees, Program Directors, agents and all other persons or entities acting on their behalf (the “Covered Parties”) and b) the lessor/owner of properties on which the Programs are held, from any and all liability, claims, or demands for personal injury, sickness or death, as well as property damages and expenses, of any nature whatsoever which may be incurred by the Participant, the Signatory, and/or any member of the Participant’s family by reason of participating in any activities associated with Christ In Youth Programs WHETHER OR NOT SUCH CLAIMS, ACTIONS, DEMANDS, LIABILITY, COSTS OR EXPENSES ARE CAUSED BY THE NEGLIGENCE OR OMISSION OF ANY OF THE COVERED PARTIES. Further, I hereby agree to indemnity and hold harmless a) the Covered Parties and b) the lessor/owner of properties on which the Programs are held, from any and all liability, claims, or demands for personal injury, sickness or death, as well as property damages and expenses, of any nature whatsoever which may be incurred by the Participant, the Signatory, and/or any member of the Participant’s family by reason of participating in any activities associated with Christ In Youth Programs WHETHER OR NOT SUCH CLAIMS, ACTIONS, DEMANDS, LIABILITY, COSTS OR EXPENSES ARE CAUSED BY THE NEGLIGENCE OR OMISSION OF ANY OF THE COVERED PARTIES. Further, I hereby assume all risk of Participant’s personal injury, sickness, death, damage, and expense as a result of the participation in this Christ In Youth Program. I hereby release and agree to hold harmless and indemnify the Covered Parties, for any liability and/or expense sustained as the result of negligent, willful, or intentional acts of the Participant, including damages to the Program facility and/or keys not returned at the time of group checkout. I agree to pay for keys not returned at time of group checkout or damage done to any Program facility or Christ In Youth property by the Participant. Publicity Release for Name, Image, and Likeness I do hereby consent and agree that Christ In Youth has the right to use the Participant’s name and image in (1) any video, audio, digital, electronic, photographic or print format pertaining to participation in the Program; and (2) any reproduction either in whole or in part from the video, audio, digital, electronic, photographic or print format pertaining to Christ In Youth’s activities and events for advertising, marketing, promotion, publicity, or any other purpose on behalf of Christ In Youth (“Produced Media”). In addition, I waive all claims to compensation or damages based on the Produced Media, and I hereby grant to Christ In Youth an irrevocable, worldwide, royalty-free, right to use the Participant’s name, voice, likeness, and image in all forms and media, and in all manners for any lawful purposes, commercial or noncommercial. I also waive any right to inspect or approve the Produced Media prior to use or publication. Finally, I agree that all Produced Media shall remain the property of Christ In Youth, unless otherwise agreed to separately from this Release Form. Processing of Personal Information and Agreement to Communication I hereby agree that the Participant’s personal information may be processed by Christ In Youth in the manner described in Christ In Youth’s privacy policy, which may be found at www.ciy.com/privacypolicy. I understand that participation in a Christ in Youth Program makes the Participant and/or Signatory eligible to receive communication about the event / program the Participant is taking part in, educational information and updates regarding ministry successes and opportunities. I hereby consent to the Participant and/or Signatory receiving communication from Christ In Youth regarding programs, education opportunities, or other areas of potential interest. I understand that I will be given the opportunity to opt-out of communication that is not related to the event / program the Participant is taking part in at a later date. If any portion of this agreement is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. I further agree this agreement will be governed by and construed in accordance with the laws of the State of Missouri without giving effect to the principles of conflict of law and the courts within Missouri will be the only courts of competent jurisdiction. I hereby irrevocably submit to the personal jurisdiction of the courts of Jasper County, Missouri. I hereby certify that I have carefully read the foregoing and acknowledge that I understand and agree to all of the above terms and conditions. I understand and acknowledge that this form is being submitted electronically. Further, I attest that the signature affixed here is that of the person named as the parent or legal guardian of the participant named herein (for those under 18) or of the participant named herein (for those 18 and over). My signature on this form transmitted in electronic format shall be treated as an original signature in all purposes. I understand that this electronic form is legally binding as if submitted as a physically signed original. I agree to all legal terms. Christ in Youth – PO Box B, Joplin, MO 64802 – 417-781-2273 – www.ciy.com

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