LIABILITY RELEASE :

In being accepted and allowed to participate in the LOVE Wichita project and activities at various locations, I assume responsibility for my actions. I release my church, its trustees, employees, missionaries, pastors and agents from liability, loss, injury or damage to myself or my property. Nothing contained herein shall excuse my church, its trustees, employees, missionaries, pastors or agents from responsibility to act with reasonable care for the safety of myself or my property. I hereby release my church, its staff, its trustees, employees, missionaries, pastors, agents, or sponsors of this activity for responsibility and liability for any injury or illness that I may sustain during this activity. In the event of an emergency, I hereby authorize an adult leader of this activity (affiliated with my church or sponsoring agency), as an agent of me, to consent on my behalf to medical treatment. In this regard I consent to allow said adult to authorize medical, dental, or surgical diagnosis; X-ray examination; treatment including surgery; and hospital care for me if needed, and if advised and supervised by a licensed physician, surgeon or dentist.