EMERGENCY INFORMATION

EMERGENCY MEDICAL & LIABILITY RELEASE

Our church's insurance is only secondary insurance. If you have medical insurance, your carrier will be billed for medical charges in the case of illness or injury while your child is on a church-related activity. "In the event that I cannot be reached in an emergency, I hereby give my permission to the physician or dentist selected by the church leadership to hospitalize, to secure proper treatment, and/or order an injection of anesthesia or surgery for my child as deemed necessary." Every activity sponsored by this church is carefully planned and adequately supervised by mature adults. However, even with the best planning and precaution, unforeseen events can occur. By signing this form, the parent or guardian agrees to assume and accept all risks and hazards inherent in church-related social activities. They agree not to hold the church or its employees or volunteers liable for damages, losses, or injuries to the person or property undersigned. The parents or guardians understand that they are signing for the minor listed on this form and the signature for both a medical and liability release. Also, by signing this release, you give permission for your child to be sent home for any disciplinary reasons.