Waiver and Consent to Medical Treatment
I, the undersigned parent/legal guardian of the named student, do hereby grant my permission and consent for said student to receive emergency medical care if:
1) Such care is deemed necessary by the adult supervisor having custody of my student.
2) The proposed medical treatment or procedures are immediately or imminently necessary and any delay occasioned by an attempt to obtain my personal consent would reasonably jeopardize the life, health, or well being of the student affected.
3) I cannot be personally contacted.
I also agree to pay all fees and costs arising from this action to obtain medical treatment.
Release of Liability
By signing this permission/waiver form, I expressly warrant that the student named above is capable of withstanding the physical demands of activities discussed above. I also expressly assume all risks of the student's or my participating in the activities, whether such risks are known or unknown to me at this time. I further release Central Assembly of God and its minister, leaders, employees, volunteers or agents. I further agree to indemnify and hold harmless Central Assembly of God and its ministers, leaders, employees, volunteers or agents from any and all claims arising from my participation in its activities and programs, or as a result of injury or illness of my student during such activities.
On occasion, Central Assembly of God takes photographs or makes audio or video tape recording of students and/or adults involved in activities. Such photographs or video records may be used by staff and participants to remember the activities or participants. In addition, such photographs and audio/visual recordings may be used in Central Assembly of God publications or advertising materials to let others know about our ministry. In addition, local news organizations may hear of our activities or events, and our church may invite or allow them to photograph or record our events for news reporting on special interest features. I consent to the use of any such audio or visual record of the student named above to be used, distributed, or displayed as agents of the church see fit. This consent includes but is not limited to: photographs, videotape and audio recordings. Furthermore, I give permission for the student to be interviewed by the news media, or for such photographs and other audio or visual records to be used by the news media.