General Release of Liability

for Centralia Community Church

I, the above listed name, HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES being conducted at or sponsored by Centralia Community Church of God (hereafter the “Church”).

I represent that our Organization has general liability insurance with coverage limits of $1,000,000 in effect as of the date of the Activity. I agree to name the Church as an additional insured on our general liability insurance policy and shall provide proof of such additional insurance coverage to the Church prior to the date of the Activity.

I understand and agree that neither the Church, nor its trustees, representatives, employees, and agents may be held liable in any way for an occurrence in connection with the Activity which may result in injury, harm, or other damages to the undersigned, invited or not. Rather, I agree that the Organization/Overseer alone shall be responsible for any property damage, personal injury, or death that may occur during our use of the premises.

As part of the consideration for being allowed to use the C3 facility, building, and grounds as well as all appliances and fixtures in the activity, I release the Church, its trustees, employees, agents, or representatives from any claim for damages, injury or death which may occur while participating in the Activity. I further agree to save and hold harmless the Church, its trustees, employees, agents, or representatives from any claim arising out of or participation in any form or fashion in the Activity.

I acknowledge that I and all adult attendees who work with youth or children, have read and understand the Policy and agree at all times to abide by all terms and provisions of the Policy. In addition, neither the undersigned nor any adult (who works with youth or children) of any function held at C3 have been accused of, charged with, or participated in any activity in violation of law related to child abuse or neglect or any activity in violation of any term or provision of the Policy.

I further state that I am authorized to sign this agreement; that I understand the terms herein are contractual and not mere recital; and that I have signed this document of my own free act and volition. I further state and acknowledge that I have fully informed myself of the content of this affirmation and release by reading it before I signed it.

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