PARENT DISCLAIMER:

CONSENT AND CERTIFICATION

I, being the parent or legal guardian of the youth named above, do hereby consent to the participation of my youth in all the scheduled youth activities of Grace Baptist  Church in Coatesville, Indiana, and any other supervised activities customarily associated with its youth group, including youth rallies and overnight, weekend, or extended time youth trips. Further, I certify that my youth is physically fit and adequately prepared to participate in all recreational and sporting events. If I wish to revoke this consent for any reason, I will promptly notify the youth leader in writing. MEDICAL TREATMENT AUTHORIZATION I understand that I will be notified in the case of a medical emergency. However, in the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event that my youth is injured or becomes ill. I authorize youth workers and supervisors appointed by Grace Baptist Church leadership to make emergency medical care decisions on behalf of my youth, if required by law or a health care provider. I authorize these persons to act in my place to consent to all necessary and appropriate x-ray examinations, anesthetic, medical or surgical diagnosis or treatment, and hospital care. I understand that Grace Baptist Church or its appointed sponsors will not be held responsible for medical expenses incurred solely on the basis of this authorization. I further agree to notify the youth director in writing of any health changes that would restrict my youth’s participation in any normal youth activities. I also understand that the youth leader and designated sponsors reserve the right to restrict my youth from any activity that they do not feel is within the physical capabilities of my youth. Should it be necessary for my child to have medical treatment while participating in this activity, I hereby give Grace Baptist Church and it’s sponsors permission to act on my behalf to secure hospitalization or medical services deemed necessary and appropriate by the physician. I absolve Grace Baptist Church from all forms of negligence and wrong treatment incurred in the procurement and process of hospitalization and medical treatment. Any cost incurred shall by my sole responsibility. PHOTO RELEASE FORM I consent to my child, attending Grace Baptist Church for any function to be photographed and/or videoed . I agree that Grace Baptist Church shall have the right to use my child’s photograph, likeness , for their website, social media, promotional material, and for any other public use at any time and for any other purpose or materials the ministry deems necessary. TRANSPORTATION FORM I give permission for my youth to be transported to and from church sponsored activities in a church, rental, or private vehicle. I give permission for appointed sponsors of Grace Baptist to transport my child to locations not specifically listed on itineraries (notice will be made if this occurs). DISCIPLINE FORM I authorize Grace Baptist Church and its appointed sponsors to send my student home at my expense. I authorize Grace Baptist Church and its appointed sponsors the authority to physically restrain my child in the event that they are physically harming themselves or another child or adult. PERSONAL BELONGINGS FORM I realize that the church and/or its sponsors are not responsible for personal belongings damaged, lost or stolen during any events gatherings, or trips.

 

By registering my child for this event, I agree to all of the statements above in relation to the child registered.