Participation Authorization and Consent to Photograph

By clicking “I accept” below, I, the “Participant”, have chosen to participate in the following activity / activities of Christian Union, Inc. (“Christian Union”): Nexus Conference, New Brunswick, NJ (the “Program”) that Christian Union will be participating in, sponsoring, or conducting on or about the dates of February 23-25, 2018.

Photo/Video Release
I give permission for pictures or videos in which I may appear as a Program Participant to be used in brochures, flyers, videos and/or other promotional materials published and distributed by Christian Union.

Permission to Treat
I authorize Christian Union to serve as my agent for determining the need of, and for authorizing, any diagnosis, treatment, and medical care (including, but not limited to determining the type of health care professional and hospital care needed) determined by Christian Union to be advisable during the Program.

I understand this authorization is given in advance of any specific diagnosis, treatment, or medical care being required and is given to provide authority and power on the part of Christian Union to give specific consent to any and all such diagnosis, treatment, or medical care that the health care professional in the exercise of his or her best judgment may deem advisable.

Release and Hold Harmless
I recognize and fully understand that there is the possibility of injury to person and property due to my participation in the Program and related activities.

In addition, I recognize and fully understand that my participation in the Program may involve potentially hazardous activities and the accompanying risks of participating in such activities, including but not limited to traveling to and within countries and locations outside of the United States.

I assume all of the foregoing risks of these activities and accept personal responsibility for any damages and loss following any loss of property, personal injury, permanent disability, or death resulting therefrom.

As consideration and as a condition for my participating in the Program, I hereby voluntarily for myself, my heirs, assigns, executors, administrators, and personal representatives, forever release, discharge, and agree to indemnify and hold harmless Christian Union and its employees, directors, trustees, officers, agents, and volunteers (“Related Parties”) from and against any and all claims, demands, actions, or causes of action of any kind (including but not limited to claims related to the diagnosis, treatment, and medical care of myself, claims due to personal injury, death, or property damage, or claims alleging negligent acts or omissions of Christian Union or its employees, directors, trustees, officers, agents, and volunteers) which may arise out of, result from, or in any way be connected with my participation in the Program. I further agree to forever indemnify and hold harmless Christian Union and anyone acting on the behalf of it, for any and all attorney’s fees or other costs incurred as a result of defending or enforcing this agreement.

I acknowledge and fully understand that by clicking “I accept” below I have agreed to release Christian Union, Inc. and all other Related Parties identified herein from any and all claims or lawsuits of any kind arising out of or resulting from my participation in the Program. I have had sufficient opportunity to review this entire document, have read and understood this agreement, and agree to be bound by its terms.