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Adult Medical Release Form

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Address*

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Release, Waiver and Indemnity Agreement

I, the undersigned, wish to voluntarily participate in the above named event. I, the undersigned, fully recognizing the dangers and hazards inherent in the event, and any related transportation, including personal injury, property damage, or wrongful death, as well as the unknown dangers and hazards which may arise in the course of my participation in the event, do hereby voluntarily: Agree, for myself, my heirs and my personal representative, to defend, hold harmless, indemnify, release and forever discharge, to the broadest extent allowed by law, Matthew Road Baptist Church, its trustees, officers, employees, agents, insurers, successors, assigns, from and against any and all claims, demands, actions, or causes of action on account of any damage to real or personal property or any personal injury or death that may result from my participation in the above event. I have read this release, I understand it fully, I understand that it is legally binding, and I understand that, among other things, I am agreeing to indemnify Matthew Road Baptist Church, for injuries, damages or losses I may cause and giving up rights to sue Matthew Road Baptist Church for injuries, damages or losses I may incur. 

I give Matthew Road Baptist Church and/or its Agents permission to seek Emergency Medical Treatment in the event I am unable to seek Emergency Medical Treatment on my own.

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Additional Information

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