REGISTRATION AND LIABILITY RELEASE

I, the parent(s) or guardian(s) listed above, hereby consent to my child identified above, participating in the activities connected with the WFBA Summer Volleyball Program sponsored by West Florida Baptist Church (WFBC). I certify that my child is able to participate in any and all of these activities. If my child has medical conditions which may be relevant to a physician in the event of an emergency, I have listed them above. In the event that an emergency occurs, I may be reached at the telephone number listed above. If I cannot be reached within a reasonable period of time, as determined by school/church officials, I hereby authorize the church or the adult sponsor Robin Whiting, David Minter, or Lindsay Whiting to make emergency medical decisions for my child. If there are any activities that I do not want my child to be involved in, I have listed them above.

I UNDERSTAND AND HEREBY AGREE TO ASSUME ALL OF THE RISKS WHICH MAY BE ENCOUNTERED ON SAID ACTIVITIES, INCLUDING ACTIVITIES PRELIMINARY AND SUBSEQUENT THERETO. I do, for myself and for my child, heirs and assigns, hereby irrevocably and unconditionally release, acquit and forever discharge West Florida Baptist Church and its agents, employees, and volunteers from any and all liability, actions, causes of actions, claims, expenses, obligations and damages of any nature whatsoever, which I now have or which may arise in the future, in connection with my child's participation in the described activity or in any other associated activities including, but not limited to, any injury to my child or property, even resulting in death.

I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as permitted by the law of the State of Florida and that if any portion hereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement of between the parties hereto.

I know of no reason why my child would not be eligible to participate in athletic competition at WFBC and my child is in physical condition to participate in athletic competition at WFBC. I know the risks involved in athletic participation, understand that serious injury, including the potential for a concussion, injury, or even death is possible in such participation, and choose to accept such risks. I voluntarily accept any and all responsibility for my child's safety and welfare while participating in athletics, with full understanding of the risks involved. l agree to adhere to the rules that govern the sport my child is participating in and will hold WFBC harmless and will accept responsibility and liability for any injury or claim resulting from athletic participation and agree to take no legal action against WFBC because of any accident or mishap involving my child's athletic participation. I also understand that by my not completing this consent and release from liability form that my child will not be able to participate in athletic competition at WFBC.

I further state that I HAVE CAREFULLY READ AND UNDERSTAND THE FOREGOING RELEASE, AND KNOW THE CONTENTS HEREOF AND I COMPLETE THIS RELEASE AS MY OWN FREE ACT. By submitting this form, I agree to my child participating in any and all activities associated with this program whether noted or not unless stated below. I understand that this is a legally binding agreement.

By submitting this form, I am agreeing to have and maintain health insurance on my child. and will be responsible for any accident that occurs during the above mentioned activity or on WFBC premises.