By signing this medical consent and liability form, I expressly assume all risks to the child participating in the activities, whether such risks are known or unknown to me at this time. I further release the church and its ministers, leaders, employees, volunteers and agents from any claim that my child may have or that I may have against them as a result of injury or illness, including COVID-19, incurred during the course of participation in these activities. This release of liability is also intended to cover all claims that members of the child's or my family or estate, heirs, representatives or assigns may have against the church or its ministers, leaders, employees, volunteers or agents. I further agree to indemnify and hold harmless the church and its ministers, leaders, employees, volunteers, or agents from any and all claims arising from my participation in its activities, programs, and trips or as a result of injury or illness of my child during such activities.
I give my permission for my above named child to participate and be taped and/or photographed in all activities, programs, and trips sponsored by Smyrna First United Methodist Church. Smyrna First United Methodist Church has my permission to use photographs/videos of my child, including but not limited to: publicity, copyright purposes, illustration, advertising, and web content. Prior to the participation of my child, I acknowledge that there are certain risks associated with these activities, including, by way of example, physical injury due to activity-related accidents, and physical injury due to transportation-related accidents, illness or even death. In addition, I acknowledge that there may be other risks inherent in these activities of which I may not be presently aware.
First Aid & Emergency Medical Treatment
I recognize that there may be occasions where the child named above may be in need of first aid or emergency medical treatment as a result of an accident, illness, or other health condition or injury. I authorize an adult, in whose care my child have been entrusted, to consent to any emergency medical treatment, and, In so doing, I agree to pay all fees and costs arising from this action to obtain medical treatment. In the event of an emergency in which I cannot be reached, the physician listed above and the local hospital are hereby authorized to provide any emergency care deemed necessary for my child. I also authorize the transfer of my child's health records to the local hospital.
Parent of Minor under 18 years of age
I represent that I am the parent/legal guardian of the child listed above, who is under 18 years of age. I have read the above Medical Consent & Liability Form and am fully familiar with the contents thereof. I give permission for the child named above to participate in the activities of this church. I hereby consent to the Medical Consent and Liability Form, including the Release of Liability above, on behalf of the child, and agree that this Medical Consent and Liability Form shall be binding upon me and