Minor Release Form Name of Minor Participant(Required) First Last Age of Minor Participant(Required)Name of organization/school/class/etc.(Required)Name of Parent or Legal Guardian(Required) First Last Emergency Contact Phone Number(Required)RESPONSIBILITY AND MEDIA RELEASE: RESPONSIBILITY RELEASE: As a parent or guardian of a child participating in one of World Hunger Relief Inc. field trip, farm tour, volunteer program, farm camp, or other program I wish to make clear my understanding that World Hunger Relief, Inc., P.O. Box 639, Elm Mott, Texas 76640, does not assume any responsibility for loss of property, damage to the same, personal harm or illness that may occur; and I, for myself, my child, executors, administrators, distributes, and assigns, in considerations, do hereby absolve World Hunger Relief, Inc. and hold them harmless from any claim of demand which I or they might conceivably assert upon the basis of the foregoing. SUNSCREEN, BUG SPRAY, FIRST AID and MEDICATIONS RELEASE: I hereby grant permission to World Hunger Relief Inc. to administer sunscreen or bug spray to my child, as needed. I authorize World Hunger Relief, Inc. to administer first aid to my child, if necessary, including, but not limited to: bandages, antibiotic ointment, antihistamine, and itch cream. WARNING: UNDER TEXAS LAW (CHAPTER 75A, CIVIL PRACTICE AND REMEDIES CODE), AN AGRITOURISM ENTITY IS NOT LIABLE FOR ANY INJURY TO OR DEATH OF AN AGRITOURISM PARTICIPANT RESULTING FROM AN AGRITOURISM ACTIVITY. MEDIA RELEASE: I hereby grant permission to World Hunger Relief Inc to take photographs and video of my child in connection with World Hunger Relief Inc. I authorize World Hunger Relief Inc to copyright, use, and publish the same in print and/or electronically. I agree that World Hunger Relief Inc may use such photographs and video of my child with or without my name and for any lawful purpose, including for such purposes as publicity, illustration, advertising, and Web content. WARNING: UNDER TEXAS LAW (CHAPTER 75A, CIVIL PRACTICE AND REMEDIES CODE), AN AGRITOURISM ENTITY IS NOT LIABLE FOR ANY INJURY TO OR DEATH OF AN AGRITOURISM PARTICIPANT RESULTING FROM AN AGRITOURISM ACTIVITY. MEDIA RELEASE: I hereby grant World Hunger Relief Inc to take photographs of me in connection with the volunteer program/retreat. I authorize World Hunger Relief Inc to copyright, use, and publish the same in print and/or electronically. I agree that World Hunger Relief Inc may use such photographs of me with or without my name and for any lawful purpose, including for such purposes as publicity, illustration, advertising, and Web content.Consent Signature(Required)NameThis field is for validation purposes and should be left unchanged.