As consideration for Point Loma Nazarene University’s permission to use its facilities and services:

I knowingly and voluntarily release, acquit and forever discharge Point Loma Nazarene University and its related persons from any and all charges, complaints, claims, liabilities, obligations, promises, agreements, controversies, damages, actions, causes of action, suits, rights, demands, costs, losses, debts, and expenses of any nature whatsoever, known or unknown, suspected or unsuspected, foreseen or unforeseen, matured or unmatured, which exist, have existed, or may arise from any matter whatsoever occurring, including, but not limited to, any claims arising out of or in any way related to my and my dependents’ presence on the campus of Point Loma Nazarene University which I or my dependents have or hereafter may have, own or hold against Point Loma Nazarene University or its related persons.

In case of illness or injury, I hereby authorize emergency medical treatment for myself or my unaccompanied minor children (named below) and agree to assume full responsibility for any such treatment, including payment of costs and any claims arising from or associated with such medical treatment.

By executing this Release Agreement, I am waiving all my and my dependents’ claims against Point Loma Nazarene University and its related persons arising under common law or any federal, state or local laws of any state.
 

Print Name	Date
_______________________________________	_______________________________________

 

 

Sign Name
Name of Unaccompanied Minor Child:
 

_______________________________________

 

* Since there may be times when you and your child are attending separate activities, it is important that we have a separate Medical Authorization for each of you in the event of a medical emergency.