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Waiver and Contact Information
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Teen's Name
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First
Last
Phone Number
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Email
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Address
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State
Zip Code
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Parent or Legal Guardian's Name
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First
Last
Phone Number
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Email
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*Parent or Legal Guardian's Address if different
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State
Zip Code
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I am the parent or legal guardian of the listed teen above. I warrant that I possess all the rights, powers, and privileges of a parent or legal guardian necessary to execute this document with binding legal effect. I certify and affirm that my child will participate in certain activities which carry with them a degree of risk and danger. I consent to my child’s participation in these activities. I acknowledge and understand that this PARENTAL AUTHORIZATION, CONSENT AND RELEASE has the same force and effect regardless of whether the activities engaged in are free or if a fee is charged. Further, I personally assume, on my child’s behalf, all risk in connection with said activities for any harm, injury or damages that may befall my child as a result of my child’s participation in the activities, whether foreseen or unforeseen, and I still wish to allow my child to proceed with the activities. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless GOOD NEWS BAPTIST CHURCH, from any and all claims, demands, or causes of action, which are in any way connected with my child’s participation in these activities.
I understand that it is my obligation to inform the church of any and all health considerations or medical conditions that would restrict my child’s participation in any and all activities while in the care of GOOD NEWS BAPTIST CHURCH. Should the need for medical attention arise the church will attempt to contact me as soon as practicable under the circumstances.
In cases of emergency, I further consent to the examination or treatment of my child by a physician duly licensed to practice medicine in the United States of America or any health care professional duly licensed to provide heath care serviced in the United States of America for medical care and services deemed necessary by the doctor, its agents, servants, and employees. I give permission to the doctor or health care professional to provide any and all medical care they deem, in their professional opinion, to be necessary. I agree to pay for any and all medical expenses incurred as a result of the use of this consent.
I acknowledge by signing this document, that if anyone is hurt or property is damaged during my child’s participation in these activities, I may be found by a court of law to have waived my right to maintain a lawsuit against the church on the basis of any claim form which I have released them herein. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions remain in full force and effect. I have fully informed myself to the contents of this PARENTAL AURTHORIZATION, CONSENT AND RELEASE by reading it before I signed it.
By checking the following box, I am stating that I have read and agree to the waiver of liability above.
*
Yes, I have read and agree to the above waiver of liability.
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Home
About Us
Meet Our Staff
What We Believe
Ministries
AWANA
Ladies Ministries
Men's Ministries
The Golden Group (Senior Adults)
VBS
Unlimited - Youth Ministry
Giving
Sermons
Contact Us