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LIABILITY RELEASE FORM
RELEASE OF ALL CLAIMS
Scotland Christian Outreach Teams, LTD.
143 Dogwood Drive, Bernville, PA 19506
In consideration for being accepted by the General Missions Director, Dr. William P. Orr, for participation in the prototype trip to develop and arrange a new project called SCOT 08 under the auspices of the Scotland Christian Outreach Teams, LTD., and
Calvary Bible Fellowship Church, Sinking Spring, PA,
I______________________________. Do hereby release, forever discharge, and agree to hold harmless, Dr. Orr, and the Board of Directors for the non profit charitable organizations created under IRS rules and regulations by a name sometimes called S.C.O.T., Ltd., its associated staff and volunteer and workers, from any and all liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses, or any nature whatsoever which may be incurred by the undersigned and by any participant that occurs while said person is participating in the above described trip or activity including recreation and work activities. The undersigned hereby further agrees to held harmless and Indemnify said organization, its directors, volunteers, employees and agents for any liability sustained by said acts of said participant, including expenses incurred attendant thereto.
Signed this ______________ Day of ________________________
The undersigned further consents to the administration of first-aid and / or doctor’s care, or any other form of medical treatment necessitated by illness or injury that may require the same. In the event of the necessity of such care or treatment herein described, the undersigned agrees to hold harmless and indemnify said organization, its directors, employees and agents from any acts of malfeasance, and / or failure to act on the part of those chosen to administer medical care on behalf of the participant.
Participant’s Medical Insurance Company: _____________________________________________
Policy number: ____________________________________________
Group number: ____________________________________________
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