Accident Waiver and Release of Liability

The undersigned hereby assumes any and all risks associated in participation in "Altered Hearts Ministries, Inc.,"
including, by way of example and not limitation, any risks that may arise from any negligence on the part of the
persons or entities being released, from dangerous or defective equipment or property owned, maintained or
controlled by them, or because of their possible liability without fault. The undersigned further acknowledges
that this Accident Waiver and Release of Liability will be used by “Altered Hearts Ministries, Inc.” the organizer
of the dance, gymnastics, tumbling, cheer and aerial classes, in which I may participate and that it will govern my
actions and responsibilities at said events. In consideration of my application and permitting me to participate in
"Altered Hearts Ministries, Inc.," the undersigned hereby takes action for myself, my executors, administrators,
heirs, next of kin, successors, and assigns as follows: (A) I WAIVE, RELEASE, AND DISCHARGE from any and all
liability, including, but not limited to, liability arising from the negligence or fault of the entities or persons
released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which
may hereafter occur to me, THE FOLLOWING ENTITIES OR PERSONS: Altered Hearts Ministries, Inc. and those
representing Altered Hearts Ministries, Inc. as volunteers and contract labor. (B) I HOLD HARMLESS, AND
PROMISE NOT TO SUE the entities or persons mentioned paragraph (A) from any and all liabilities or claims
made as a result of participation in "Altered Hearts Ministries, Inc.," whether caused by negligence or otherwise.
I further acknowledge that "Altered Hearts Ministries, Inc." like any such physical activity, may carry with it the
potential for death, serious injury, and personal loss. The risks may include, but are not limited to, those caused
by terrain, facilities, temperature, weather, condition of participants, equipment, and the actions of other
persons including, but not limited to, other participants, staff, volunteers, and spectators. (C) I consent and
agree that this accident waiver and release of liability shall be construed broadly to provide a release and waiver
to the maximum extent permissible under applicable law. The undersigned hereby attests that he/she is at least
18 years old and, if applicable, further attests that I am the parent or legal guardian of any minor child or minor
children listed below and that as the parent or legal guardian I have full legal authority to authorize their
participation in "Altered Hearts Ministries, Inc." and agree to all terms in the above Accident Waiver and Release
of Liability.
Name: ______________________________________
Date: _______________________________________