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Parish Nurse Ministry Waiver Form

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Parish Nurse Ministry

WAIVER & RELEASE FORM


Because physical exercise can be strenuous and subject to risk of serious injury, you are
urged to obtain a physical examination from a doctor before participating in any exercise
activity. You agree that by participating in physical exercise or training activities, you do
so entirely at your own risk. You agree that you are voluntarily participating in these
activities and use of these facilities and premises and assume all risks of injury, illness
or death.
You acknowledge that you have carefully read this waiver and release and fully
understand that it is a release of liability. You expressly agree to release and discharge
the instructor, parish nurse, Rejoice! Lutheran, Christ Church Episcopal, First
Presbyterian Church of Hudson, the governing church bodies and Laurel Lake Retirement
Community from any and all claims or causes of action and you agree to voluntary give
up or waive any right that you may otherwise have to bring a legal action against the
aforementioned entities.
To the extent that statute or case law does not prohibit releases for negligence, this release
is also for negligence.
By signing this release, I acknowledge that I understand its content and that this release
cannot be modified orally.
Signed: _______________________________
Printed Name: __________________________
Date: ____/____/____

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