LIABILITY RELEASE FORM WEGO Ministries I Your N by ycj19432


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									                                   LIABILITY RELEASE FORM
                                           WEGO Ministries

    I ________________________________________
                       Your Name

    Parent or Guardian of _______________________________________
                                      Child’s Name, if applicable

    do hereby for myself, my child, and heirs, remise, release, and forever discharge Worldwide
    Evangelical Gospel Outreach Inc., of Cocoa Beach, FL. and its officers from all claims, demands or
    actions or causes of actions of any kind including illness, death, injury or property damage which
    would occur from any cause other than gross negligence of the part of Worldwide Evangelical
    Gospel Outreach, Inc. during the trip to __________________ on ______________________
                                                        Destination                 Dates of Trip
    This includes all flight and ground travel incident to this trip. We understand that Worldwide
    Evangelical Gospel Outreach, Inc. is in no way to be held accountable for the gross negligence of
    any team members or participant which leads to any of the above mentioned actions.

    ________________________________                                ___________________
    Participant/Parent/Guardian                                     Date

STATE OF _____________

COUNTY OF ____________

I hereby certify that ______________________________________________ (printed name)

(    )who is personally known to me; and/or (               )who has produced a driver license

Number _____________________as identification, did sign above Liability Release Form

in my presence this _______ day of ____________, 2005.

Signed and sealed this ____ day of ____________________, 2005

Notary Public Signature

(SEAL)                                                  My commission expires: __________________

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