Release of Liability and Consent to Treatment *

Acknowledgment and Assumption of Risk I acknowledge that I am voluntarily staying at the EMCI Mission Center located at: I understand that EMCI/EMCM has taken reasonable precautions to ensure the safety and cleanliness of the facility, but I also acknowledge and accept the following: 1. I am responsible for my own health, safety, and personal belongings during my stay. 2. I assume all risks associated with staying at the mission center, including but not limited to: Slips, trips, or falls Illness or injury Loss or theft of personal items 3. I agree to conduct myself in a respectful and responsible manner, and to follow all guidelines or instructions provided by EMCI/EMCM staff. Release of Liability In consideration of being allowed to stay at the EMCI Mission Center, I hereby release, waive, and discharge EMCI/EMCM, its officers, employees, volunteers, and affiliates from any and all liability, claims, or demands of any kind related to injury, loss, or damages that may arise during or as a result of my stay. Medical Treatment Consent In the event of an emergency, I authorize EMCI/EMCM staff to seek appropriate medical attention on my behalf. I understand that I am financially responsible for any medical treatment provided.

By checking this box, I confirm that I have read, understood, and agreed to the terms of this waiver and release of liability.