Emergency Contact Information
Medical Insurance Information
I expressly release and agree to hold harmless Magnolia Cowboy Church and their sponsors, volunteers, officers, directors, shareholders, representatives, employees, agents and affiliates from any and all claims or liabilities whatsoever from my participation in the Man Camp Event on November 7, 2025 - November 9, 2025. Including, but not limited to, claims as a result of personal injuries, property damages, accidents or illnesses (including claims caused in whole or in part by the negligence of the sponsors) that I may suffer which may arise during, or in connection with, this event. I further expressly assume the risk of any personal injuries, property damages, or any other damages of any nature which I may sustain in connection with my participation in the event.
I further give the sponsors permission to use my name and reproductions of my voice and likeness. These reproductions may be in the form of audio recordings, photographs, motion pictures, and videotapes or in any other form. The sponsors may use my name and reproductions of my voice or likeness, whether altered or not, for any promotional and business purposes whatsoever, including use on the airwaves and in print media. I understand that in the event my name or reproductions of my voice or likeness are utilized for promotional or other purposes, I will receive no compensation for such use, and I hereby expressly release the sponsors from any claim or liabilities arising out of the use of my name or reproduction of my voice or likeness.
Authorization for Treatment: In an emergency, I hereby consent for the church event leader to seek medical attention on my behalf, as deemed necessary. I give my permission to medical personnel and the medical facility selected to secure and administer treatment, including hospitalization, on my behalf. I understand that medical and accident insurance protection are my responsibility.
