Mission Liability Waiver and Medical Release
NOTICE: This is a binding legal document. Please read carefully and sign. Consult an attorney if you have
any questions. It is a release of claims and hold harmless for future accidental injuries or death of the
participant and all of his or her family members. It is also an authorization for emergency medical or
dental care for the participant.
- I have inquired about the activity to my satisfaction and am aware of all the inherent dangers and
hazards of the above activity/event and the benefits to be gained by myself, the participant, engaging in
- By signing this form, I understand and agree that neither Buffalo Dream Center, hereinafter known as
BDC, nor its agents, officers, directors, employees, volunteers, or ministry partners may be held liable in
any way for any occurrence in connection with the above activity/event which may result in illness,
injury, death, or other dangers to myself, the participant, or my heirs, family members, or assigns. I
waive any such claim for compensation, liability, or reimbursement of any incurred expenses as a result
of illness, injury, death or other medical expenses.
- By signing this form, I understand and agree that neither the BDC, nor its agents, officers, directors,
employees, volunteers, or ministry partners may be held liable in any way for any lost, stolen, or
damaged property belonging to myself, the participant, or my heirs, family members, or assigns. I waive
any such claim for compensation, liability, or reimbursement of incurred expenses.
- For being allowed to participate in the above activity/event, myself, the participant and all my family
members, heirs, or assigns personally assume all risks in connection with the activity. I release BDC, its
agents, officers, directors, employees, volunteers, or ministry partners from any injury or damage, which
may befall me while engaged in the above activity/event. This release includes all risks connected with
the activity/event, whether foreseen or unforeseen. I further agree to save and hold harmless BDC and
the named persons from any claim by me, or family members, estate, heirs, or assigns arising out
of the participation in the above activity/event.
- I authorize any ambulance or hospital emergency service that may be rendered necessary to myself,
the participant. I understand that I, the participant, assumes responsibility for the payment of the
ambulance, doctor, dentist, or hospital fees. I waive any such claim for compensation, liability, or
reimbursement of incurred expenses.
- By signing this waiver, I understand that in the event I, the participant, is sent home or has to leave
early from the activity/event listed above, I assume all expenses related to and necessary for the early
departure such as but not limited to car rental, transportation expenses, gas expenses, lodging, meals,
and airfare. I waive any such claim for compensation or reimbursement of such expenses.
- Further I give my permission for any and all pictures, audio, videos, or personal testimonies to be used
in part or in whole in any and all future publications printed or recorded, (audio or video), without prior
notification or royalties by the Buffalo Dream Center
- Furthermore, I state that I, the participant, am at least 18 years of age and am legally competent to
sign this agreement and release; I understand the terms in this agreement and release are contractual
and not a mere recital; I have fully informed myself of this agreement and release by reading it before I
signed it; I have had the opportunity to consult with legal counsel regarding the effect of this agreement
and release, should I so desire; and I have signed this document of my own free act.