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I do hereby agree to hold Encounter / Christian Church Campus Ministry and its agents, officers, board members, and employees, harmless from and hereby release any and all claims arising; or which may be asserted by me or by any one else through me, or on my behalf; by reason of participation in any activities associated with Encounter / Christian Church Campus Ministry, and/or its trips and events. I also release the lessor of properties on which the event is held and his officers, agents, and employees. Further, I do authorize the ministry staff, or any Encounter / Christian Church Campus Ministry agent, officer, board member, or employee; in the event an emergency contact cannot be reached by phone, if any, noted below; to give consent to emergency workers, transporters, physicians, health care providers, and/or hospitals, etc., for my emergency medical, dental, optical, drug, surgical, or other such treatment. It is understood that I will assume all financial responsibility for expenses that may be incurred for treatment.

All participants in activities or events hosted by Encounter / Christian Church Campus Ministry recognize that COVID-19 is highly contagious and may spread through various means including person-to-person contact. By attending this event or activity, I agree to abide by its established procedures to reduce the potential of exposure and protect attendees and staff.  I also voluntarily assume the risk that I may be exposed to or infected by COVID-19 while at an Encounter / Christian Church Campus Ministry event or activity, and therefore take full responsibility for any resulting outcome. This includes holding Encounter / Christian Church Campus Ministry harmless and waving any liability against Encounter / Christian Church Campus Ministry and other participating parties.  By attending this event, I am self-certifying that I am free of COVID-19 symptoms. I will refrain from attending if I have a fever over 100.4 degrees or am showing any COVID-19 symptoms, or have been in contact with anyone with a temperature greater than 100.4 degrees or has currently known symptoms of COVID-19. Symptoms of COVID-19 are defined as: fever, cough, shortness of breath or difficulty breathing, chills, fatigue, muscle and body aches, headache, sore throat, new loss of taste or smell, congestion or runny nose, vomiting, or diarrhea.

Further, I do hereby certify that I am covered under adequate insurance. My submission of this form certifies my consent. I have read and agree severally and jointly to be bound by and to the information given in this entire form.