waiver and release

FIRST UNITED METHODIST CHURCH OF EUGENE

WAIVER AND RELEASE

First United Methodist Church 1376 Olive Street Eugene, OR 97401

office: 541.345.8764 fax: 541.485.5025

For outside groups using facilities of First United Methodist Church of Eugene, Oregon.

Please fill out this form completely. You may print it out and return it to the church office.

In consideration of the right to periodic access to and use of the premises of the First United Methodist Church of Eugene, 1376 Olive Street, Eugene, Oregon, I (name of individual signer),

as an agent of (name of organization/group),

authorized by said (name of organization/group),

to bind , it's members, assignees, volunteers, and guests and to the terms of this Waiver and Release, do agree as follows:

I, on behalf of , agree to release, waive, discharge, hold harmless, defend and indemnify First United Methodist Church of Eugene from any and all claims, actions, or losses for bodily injury, abuse, sexual misconduct/sexual abuse by any person acting as a member of , agent, thereof, or person present in the premises of First United Methodist Church of Eugene by invitation of .

I specifically understand that, by signing this Waiver and Release on behalf of , I acknowledge receipt of a copy of the First United Methodist Church of Eugene Safe Sanctuary policy on behalf of .

I further understand that by signing this Waiver and Release that I am personally accepting the responsibility to convey, in both oral and written form, a copy of this Safe Sanctuary policy to all members of .

FIRST UNITED METHODIST CHURCH OF EUGENE ASSUMES NO LIABILITY FOR ANY INCIDENT OF CHILD ABUSE OR SEXUAL MISCONDUCT/SEXUAL ABUSE WHICH TAKES PLACE UNDER THE AUSPICES OF AN OUTSIDE ORGANIZATION.

THIS CONSTITUTES A WAIVER OF LIABILITY BY FIRST UNITED METHODIST CHURCH OF EUGENE.

BY SIGNING THIS WAIVER AND RELEASE, I AGREE TO ITS TERMS ON BEHALF OF .

signature:

printed name:

group name:

date:

(revised 12/08)