In the event that I am injured while participating in Summer Retreat, June 27th–30th 2021, I do hereby authorize and consent to any x-ray, examination, anesthetic, medical, or surgical diagnosis rendered under general or special supervision of any licensed medical staff member under the provisions of the Medicine Practice Act.
It is understood that this authorization is given in advance of any specific diagnosis or treatment being required, but it is given to provide authority and power to render care which the aforementioned physician, in his or her best judgment, may deem advisable.
It is understood that effort shall be made to contact, the undersigned, prior to rendering treatment, but that any of the above treatment will not be withheld if no one can be reached. This authorization is given pursuant to the provisions of section 25.8 of the Civil Code of California.
I understand the camp setting and nature of this retreat and do hereby release Saddleback Valley Community Church, or any of its staff or representatives, volunteers or the like, for accidents or injury sustained in conjunction with CM’s 2021 Summer Retreat in Palm Springs.