Assumption of Risk
Prior to my student’s participation in sport activities, I acknowledge and fully understand that these sport
activities involve inherent risks of injury, including concussions, fractures, sprains, strains, contusions, serious
bodily harm, and even death. I recognize that the risks include collisions, falls, and contact with other participants,
equipment, and playing surfaces, as well as the potential for improper technique, fatigue, and overexertion.
Additionally, I understand that the use of protective equipment, such as helmets, pads, and mouthguards, may
reduce but not eliminate the risk of injury. I give permission for my student to be transported in an authorized
FCA vehicle to FCA activity locations and acknowledge the risk of injury due to transportation-related
accidents. I acknowledge that there may be other risks inherent in these activities of which I may not be
presently aware. I acknowledge that these risks may result from or be compounded by the actions, omissions,
or negligence of FCA or others, including negligent emergency response or rescue operations by FCA. By
signing this Permission Waiver Form, I expressly warrant that the above-named student is capable
of withstanding both the physical and mental demands of the activities. I also expressly assume all
risks of the student being on the premises and participating in the activity, whether such risks are
known or unknown to me at this time, including injury, illness, disability, death, or other loss, whether
caused by the ordinary negligence of FCA or otherwise.
Release of Liability
I expressly release FCA and its leaders, employees, Officers, Directors, volunteers and agents, and the
employees, officers, directors, volunteers and agents of the premises, venue, or facilities in which this activity
takes place (“Releasees”) from any claim that my student may have or that I may have against them as a
result of injury or illness incurred during participation in the activity and while present at the premises, venue
or facilities in which this activity takes place, whether caused by the ordinary negligence of FCA or otherwise.
This Release covers all claims that members of the student’s or my family or estate, heirs, representatives, or
assigns may have against the Releasees. I covenant not to make or bring any such claim against FCA or any
other Releasee, and forever release and discharge FCA and all other Releasees from liability under such
claims. This waiver and release does not extend to claims for gross negligence or willful misconduct.
Indemnification and Hold Harmless
I further agree to indemnify and hold harmless the Releasees from any and all claims, demands, debts, suits,
claims and causes of action, including reasonable attorneys’ fees and insurance-related costs, arising from or
related to the student’s participation in its activities and programs, or as a result of injury, illness, or other harm
incurred during such activities. This includes any claim related to the student’s own negligence or the ordinary
negligence of FCA.
First Aid and Emergency Medical Treatment
I recognize that there may be occasions where the student may need first aid or emergency medical
treatment as a result of an accident, illness, or other health condition or injury. I give permission for agents
of FCA obtain medical treatment, including hospitalization, for the student if such need arises in the agent’s
opinion. I agree to pay all fees and costs arising from this action to obtain medical treatment. I release,
discharge, and hold harmless FCA from any claim based on such treatment or other medical services.
I give permission for camp trainer and camp professional medical staff to give over-the-counter medications
as needed, and I give permission for attending physician(s) and other medical personnel to administer any
needed medical treatment, including surgery. I give permission for the student to be transported to a
medical center in an emergency, and, again, I agree to pay for any medical treatment.
FCA Student Permission Waiver Reviewed Feb. 2025
Release to Use Image and Likeness
On occasion, FCA or its representatives takes photographs or makes an audio or video recording of children
and/or adults involved in activities. I understand that these materials are the property of FCA, and grant
FCA and Releasees permission to use the student’s name, image, and likeness in a photograph, video, or
other digital media taken at the Activity. Such materials may be used in FCA publications or advertising
materials. These images and recordings may also be used by FCA or its agents to produce ministry
resources for staff training, Camp or Campus Ministries, or in other ways to promote the ministry of FCA.
FCA may also make these materials available for sale to the public. Such photographs or video records
may also be used by staff and participants to remember the activities / participants.
Local news organizations may hear of FCA activities or events, and FCA may invite or allow them to
photograph or record our events for news reporting on special interest features. I consent to the use of any
such audio or visual record of the student to be used, distributed or displayed as agents of the organization
see fit. This consent includes but is not limited to photographs, video and audio recordings.
