I give my permission to use:

for public relations, educational and/or marketing purposes by the Los Angeles Christian Health Centers. I understand that all materials will remain the property of the Los Angeles Christian Health Centers, and I am not entitled to any compensation or payment for their use.

WITNESS (LACHC REPRESENTATIVE)

SPECIAL EVENT LIABILITY RELEASE FORM

By participating in this special event you understand you participate at your own risk.

1. Assumption of Risk: I acknowledge I am participating voluntarily and do not hold Los Angeles Christian Health Centers responsible for liability, injury, death, or loss.

2. Waiver and Release: I release LACHC, its Board, and event affiliates from claims related to participation.

3. Indemnification: I agree to indemnify and hold harmless LACHC and affiliates for claims arising from my participation.

Medical Attention: I acknowledge LACHC does not provide medical care and I participate at my own risk.

I HAVE READ AND SIGNED VOLUNTARILY.