Summer Class Application

Biographical Information

Please type your full legal name

Emergency Contact

Medical Consent

I, the undersigned, do hereby grant full permission to Cottonwood College or any related or consulting physician to render any emergency medical aid, care or treatment that they deem necessary. I also understand that should extended hospitalization be required, I grant complete permission for such care and treatment to be given. This consent I give freely and voluntarily, fully knowing and understanding all the above and its relation to and effect upon me.

Photo Release

I hereby grant permission to Cottonwood Church (the "Church") to use my photograph, likeness, image, voice or performance on its Internet website, CD or DVD labels, video tape or film clips, advertisements or other official Church publications at the sole discretion of the Church and to be used in whole or in part of any and all broadcasting, audio/visual, and/or exhibition purposes in any manner or media, in perpetuity, throughout the world. 1. I have the right, capacity, and authority to enter into this agreement (herein after called "Agreement") and that my appearance and the rights I have granted in this Agreement will not conflict with or violate any commitment or understanding I have with any other person or entity. 2. I understand that once my image appears on the Church's website, the image can be downloaded by any computer user. I expressly release the Church, its officers, directors, employees, volunteers and agents from any and all claims arising out of the use of my photograph or image on the Church's website. I agree to indemnify and hold harmless the Church, its officers, directors, employees, volunteers and agents from and against all claims, losses, expenses and liabilities of every kind including reasonable attorney's fees arising out of the inaccuracy or breach of any provision of this Agreement. 3. In consideration for my appearance and/or performance on the Church's Internet website, CD or DVD labels, video tape or film clips, advertisements or other official Church publication and all rights granted hereunder, I do not require or expect any monetary or financial payment or incentive or benefit but consider my appearance and/or performance to be a form of service to the Church. 4. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. This Agreement represents the entire understanding of the parties and may not be amended unless mutually agreed to by both parties in writing. 5. I have fully informed myself of the contents of this PHOTO RELEASE by reading it before I signed it.
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