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Participant Health and Liability Release Form

Please fill out the form below as soon as you have registered for the conference! We need this form to be submitted before check-in on Friday, July 25th. 

Home Conference LCC Participant Health and Liability Release Form

Birthday
Month
Day
Year
Will you be over 18 during the conference (7/25/25-7/26/25)?
Yes, I will be over 18.
No, I will be under 18.

Transportation Notice


Participants are solely responsible for their own transportation to and from the event. Home Conference LCC and Harbor Light Community Chapel assume no responsibility for transportation arrangements or incidents occurring during transit.


Health and Safety Acknowledgment


I certify that I am (or my minor child is) physically able to participate in all event activities. I understand that should a health issue arise during the event, Home Conference LCC and Harbor Light Community Chapel do not have medical personnel on site, and emergency services will be contacted if necessary at my expense.


Release and Waiver of Liability


In consideration of participation in the Home Conference LCC event:


I voluntarily release, forever discharge, and agree to hold harmless Home Conference LCC and Harbor Light Community Chapel, their directors, officers, employees, agents, volunteers, and representatives from any and all claims, demands, causes of action, or liability for any injury, loss, illness, property damage, or death arising from my (or my minor child's) participation in the event, whether arising from the negligence of the Released Parties or otherwise.


I understand and agree that this release includes any claims based on the negligence, action, or inaction of any of the Released Parties and covers bodily injury, property damage, and death, whether suffered before, during, or after participation in the event.


Assumption of Risk


I acknowledge that participation in the event may involve inherent risks, including but not limited to physical activities, interactions with other participants, and potential exposure to illness. I knowingly assume all such risks.


Medical Authorization


In the event of a medical emergency, I authorize Home Conference LCC representatives to seek necessary medical treatment for myself (or my minor child) and agree to be financially responsible for any associated costs.



For Participants 18 Years and Older:


I understand and agree to the above terms.

Date
Month
Day
Year

For Participants Under 18 Years:


As the parent or legal guardian of the participant, I consent to their participation and agree to the above terms on their behalf.

Date
Month
Day
Year

Consent for Photography and Media Release (Optional)


I consent to the use of my (or my minor child's) image, likeness, or voice in photographs, video recordings, or other media taken during the event for use by Home Conference LCC for promotional or educational purposes.

Do you agree or disagree to the statement above?
Yes
No
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