HOPE CHURCH SOUTH HAVEN
Waiver form 2025/26

kids4Jesus & SMACK

PARTICIPANT WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

I, for myself, and on behalf of my spouse, children, guardians, heirs and next of kin, and any legal and personal representatives, executors, administrators, successors and assigns, hereby agree to and make the following contractual representations pursuant to this Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement (the “Agreement”);

1. I hereby represent that (i) I am at least eighteen (18) years of age or older; (ii) I am in good health and in proper physical condition to participate in our activities; and (iii) I am not under the influence of alcohol or any illicit or prescription drugs which would in any way impair my ability to safely participate in our activities. I agree that it is my sole responsibility to determine whether I am sufficiently fit and healthy enough to participate in the activities, that I am responsible for my own safety and well-being at all times and under all circumstances while at our activity site.

2. I understand and acknowledge that participation in our activities is inherently dangerous and represents an extreme test of a person’s physical and mental limits. I understand and acknowledge the risks and dangers associated with participation in our activities and related activities, including without limitation, the potential for serious bodily injury, sickness and disease, permanent disability, paralysis and loss of life; loss of or damage to equipment/property; exposure to extreme conditions and circumstances; contact with other participants, spectators, animals or other natural or manmade objects; dangers arising from adverse weather conditions; imperfect course or track conditions; land, water and surface hazards; equipment failure; inadequate safety measures; participants of varying skill levels; situations beyond the immediate control of the Activity Organizers; and other undefined, not readily foreseeable and presently unknown risks and dangers (“Risks”). I understand that these Risks may be caused in whole or in part by my own actions or inactions, the actions or inactions of others participating in the activities, or the negligent acts or omissions of the Released Parties defined below, and I hereby expressly assume all such Risks and responsibility for any damages, liabilities, losses or expenses which I incur as a result of my participation in any activity.

3. I agree to be familiar with and to abide by the Rules and Regulations established for the activities, including but not limited to the rules adopted by us and any safety regulations established for the benefit of all participants. I accept sole responsibility for my own conduct and actions while participating in our activities, and the condition and adequacy of my equipment.

4. I hereby Release, Waive and Covenant Not to Sue, and further agree to Indemnify, Defend and Hold Harmless the following parties: Hope Church South Haven, and Promoters, Sponsors, Advertisers, Coaches and Officials; the Host Organization and the Facility, Venue and Property Owners or Operators upon which the activities takes place; Law Enforcement Agencies and other Public Entities providing support for the Event; and each of their respective parent, subsidiary and affiliated companies, officers, directors, partners, shareholders, members, agents, employees and volunteers (Individually and Collectively, the “Released Parties” or “Event Organizers”), with respect to any liability, claim(s), demand(s), cause(s) of action, damage(s), loss or expense (including court costs and reasonable attorneys’ fees) of any kind or nature (“Liability”) which may arise out of, result from, or relate in any way to my participation in the activities, including claims for Liability caused in whole or in part by the negligent acts or omissions of the Released Parties. I further agree that if, despite this Agreement, I, or anyone on my behalf, makes a claim for Liability against any of the Released Parties, I will indemnify, defend and hold harmless each of the Released Parties from any such Liabilities which any may be incurred as the result of such claim. I hereby warrant that I am of legal age and competent to enter into this Agreement, that I have read this Agreement carefully, understand its terms and conditions, acknowledge that I will be giving up substantial legal rights by signing it (including the rights of my spouse, children, guardians, heirs and next of kin, and any legal and personal representatives, executors, administrators, successors and assigns), acknowledge that I have signed this Agreement without any inducement, assurance or guarantee, and intend for my signature to serve as confirmation of my complete and unconditional acceptance of the terms, conditions and provisions of this Agreement. This Agreement represents the complete understanding between the parties regarding these issues and no oral representations, statements or inducements have been made apart from this Agreement. If any provision of this Agreement is held to be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from this Agreement and shall not affect the validity and enforceability of any remaining provisions.

On Behalf of minor(s):

I am the parent (or legal guardian) of the below listed minors and executing this document on their behalf. Furthermore, I assume all responsibility and liability as stated above.

Information of parent/guardian #1

Information of parent/guardian #2



I/We give permission for my/our child, named above, to attend and participate in kids4Jesus and/or Smack sponsored by Hope Church in South Haven, MI.

I/We understand that all reasonable safety precautions will be taken at all times by Hope Church staff and volunteers during all events/activities.


I/We understand and agree that my child's participation in athletic and other activities of the program involves the risk of injury and even death from various causes, including but not limited to accidents, strenuous and prolonged physical activity, dehydration, illness, collision, weather related injuries, playing area and equipment defects, and negligence of adult staff and leaders. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I assume these risks.


I/We hereby release, discharge, hold harmless and indemnify, and covenant not to sue Hope Church and directors, officers, elders, deacons, employees, volunteers, insurers, agents, representatives, and all other persons associated with Hope Church Family Ministries.

I/We give permission for my /our child to ride in any vehicle driven by any adult leaders in whose care he/she has been entrusted, including permission to drive my /our child to and from youth activities.


I/We authorize the adult staff and volunteers from Hope Family Ministries to consent to any X-ray, anesthetic, medical, surgical, or dental diagnoses and/or treatment, and hospital care to be given to my /our child on the advice of a physician or dentist or a licensed hospital in the event of an emergency. I also agree to be responsible for all costs and expenses in connection with medical, dental, or optical services.


I/We consent to the use of any video images, photographs, audio recordings, or any other visual or audio reproduction that may be taken of my/our child to be used as Hope Church sees fit for brochures, video presentation on the website of Hope Church, and/or other media venues.


I/We acknowledge that if my/our child has to return home early due to discipline violations or illness, it will be at my /our expense.


I/We agree that my child is healthy and able to participate in Hope Family Ministries' activities and also agree that should my child become unable to attend these activities due to sickness or other health issues, it is my responsibility that they do not attend or participate.


I/We understand that SMACK and kids4Jesus abide by the Statement of Faith of Hope Church South Haven - https://hopesouthhaven.com/what-we-believe




Information of student #1


Information of student #2


Information of student #3


Information of student #4


By signing electronically, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via your electronic signature, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.