Emergency and Liability Release
The health information recorded on this form is correct as far as I know, and the minor child named and described above has permission to engage in all Christ Church Anglican activities except as noted. I have familiarized myself with the Program and events and understand all activities are completely voluntary. I recognize the inherent risk of injury in activities including, but not limited to, outdoor games and other activities listed on the program schedule.
While Christ Church Anglican has safety protocols in place to manage allergen related issues, I understand that a minor child with specific allergies or intolerances has a role and responsibility in the avoidance of the known allergen. I agree to educate my child, who has allergies or intolerances, to ask questions, read labels, and avoid the substance in question when in doubt.
I understand that Christ Church Anglican has taken proper safety measures to aid the safety of all participants. However, I recognize that Christ Church Anglican cannot ensure or guarantee the participants, equipment, grounds, and/or activities will be free of accident or injuries. I am aware of, and have instructed my child, in the importance of knowing and abiding by the program rules and regulations, and I voluntarily agree that Christ Church Anglican, its agents, officers, employees, and volunteers will not be liable for any injury, death, damage and/or loss to my child, and/or anyone claiming on my child's behalf, and I further agree to hold harmless, indemnify and defend Christ Church Anglican, its officers, staff, agents, employees, and volunteers for and from any and all liability, claims, losses, injuries, expenses, fees and/or damages arising out of any injury, illness or death to my child during my child's attendance at Christ Church Anglican programs.
In the event I cannot be reached immediately, I hereby grant permission for my minor child to receive basic first aid and emergency treatment for any illness or injury which requires emergency treatment, including permission to secure emergency transportation for my child to an appropriate medical facility. I understand that the information on this form may be released in an emergency situation on a need to know basis to aid in the treatment and care of my child.
Photo and Video Release
Christ Church Anglican activities may have a photographer or videographer present. Photos or video from CCA activities may later be included in some of CCA’s written materials, CCA’s social media postings, and/or CCA’s website.
I acknowledge and understand that CCA materials are subject to the following protections:
(1) CCA’s use will be for church-related purposes only; and
(2) CCA will not use any image that individually identifies a child by name or otherwise. CCA will not release any personally identifiable information without prior written consent from you as parent or guardian.