* Media Approval: Scroll over for details Select one Yes No
Proper Behavior Description - I understand that if my child repeatedly disobeys/ignores the guidelines/rules stated at the event; if my child brings any illegal drugs, alcohol, or any weapons; if my child repeatedly acts inappropriate in any way toward leaders/students; or if my child does anything else that is unacceptable or puts themselves or others at risk, I may be contacted and asked to pick up my child from the activity at my own expense. THIS IS FOR ALL CHILDREN REGISTERED.
Liability Release Description - (I), the undersigned, give permission for my child(ren) to participate in Emmanuel Baptist Church activities, we do hereby release, forever discharge and agree to hold harmless EMMANUEL BAPTIST CHURCH, its directors, employees, volunteers and agents (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and or the child(ren) while involved in Emmanuel Baptist Church activities. Furthermore, we (I) [and on behalf of our (my) minor child(ren)] hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in activities involved therein. THIS IS FOR ALL CHILDREN REGISTERED
Medical Release Description - We (I) authorize an adult, in whose care the minor has been entrusted, to consent to any emergency x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care, to be rendered to the minor under the general or special supervision and on the advice of any physician or dentist licensed on the medical staff of a licensed hospital or emergency care facility. The undersigned shall be liable and agree(s) to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child or youth pursuant to this authorization. It is understood that a conscientious effort will be made to notify me (parents/guardians) before such action will be taken. I agree to accept responsibility for the cost of above medical services through my standard family insurance coverage, and I have listed that information below. This is for ALL CHILDREN REGISTERED
* CONSENT: By choosing YES I agree that all of the above information is correct to the best of my ability and I agree to the terms provided. Select one Yes
