Universal Permission Slip

Below is a Universal Permission Slip that I would advise having Teens and Parents to sign every year.


I agree to hold harmless and indemnify Clays Mill Road Baptist Church and the teen workers, for any and all loss or damage I may cause to person or property during activities. This includes, but is not limited to, any and all claims for personal injury, death and/or property damage that may arise out of the use of the equipment, or any equipment, regardless of whether such loss or damage be caused to myself or to others.


I hereby release Clays Mill Road Baptist Church and its workers, from any and all liability to me or my property  I acknowledge that I am freely and expressly assuming and accepting any and all risks of property damages, personal injury or death as the user of this equipment.


I authorize the workers from Clays Mill Road Baptist Church to administer treatment in the event of an injury to the the minor for whom I am signing. I understand I must observe all verbal & posted warnings or instructions and I must keep off closed lanes and out of closed areas.

I agree that if any portion of this agreement is determined to be unenforceable by a court of law, all other parts of the agreement shall remain in full force and effect. I further agree that I will not bring any claim against Clays Mill Road Baptist Church or its workers


I have read the above paragraphs and fully understand them. I, the undersigned, acknowledge that I have read this agreement and release of liability and I understand its contents. I understand that my signature below expressly waives any rights I may have to sue Clays Mill Road Baptist Church or its workers for injuries and damages.


Name of Teenager(s):




Parental Guardian: