Indemnity and Release Form

Thank you for participating with Global Gates. All participants must read, sign, and date the Indemnity and Release Form in order to participate. If you are completing this for a minor (17 and under) please include their name and date of birth below.

Step 1: Contact Information

Person Completing Form Name(Required)

First Last

Email(Required)

Your email will not be shared with third parties and will only be used if there is a need to follow-up with you or if we have a problem with your file.

Your Church or Organization (Name and City/State)(Required)

Step 2: Indemnity and Release Form

I, the undersigned, wish to voluntarily participate with Global Gates.

Trip or Event Location (City, State, and Country)(Required)

Start Date of Trip(Required)

I, the undersigned, fully recognizing the dangers and hazards inherent in the Global Gates Gathering or event, and any related transportation, including personal injury, property damage, or wrongful death, as well as the unknown dangers and hazards which may arise in the course of my participation in the Global Gates Gathering or event, do hereby voluntarily: Agree, for myself, my heirs and my personal representative, to defend, hold harmless, indemnify, release and forever discharge, to the broadest extent allowed by law, Global Gates Network Inc., its trustees, officers, employees, agents, insurers, successors, assigns, from and against any and all claims, demands, actions, or causes of action on account of any damage to real or personal property or any personal injury or death that may result from my participation in the above Global Gates Gathering or event. I have read this release, I understand it fully, I understand that it is legally binding, and I understand that, among other things, I am agreeing to indemnify Global Gates Network, Inc., for injuries, damages or losses I may cause and giving up rights to sue Global Gates Network, Inc. for injuries, damages or losses I may incur.

Signature of Participant (or of Parent/Guardian if Participant is a minor)(Required)

Parent Guardian/Name (if Participant is 17 and under)

Minor's Name (if Participant is 17 and under)

Minor's Date of Birth (if Participant is 17 and under)

Date of Signature(Required)