TO WHOM IT MAY CONCERN: The undersigned hereby give permission for our (my) child To attend and participate in the Pleasant Valley Evangelical Church youth and children's ministry activities, events and retreats during the 2019 year.
LIABILITY RELEASE: In consideration of Pleasant Valley Evangelical church youth and children's ministries allowing the Participant to participate in group activities, we (I) the undersigned, do hereby release, forever discharge and agree to hold harmless Pleasant Valley Church, it's directors, employees, volunteers, and agents (collectively herein PVC) from any and all liability claims or demands for accidental injury, sickness or death, as well as property damage and expense, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in youth/children's activities. We (I), the parent(s) or legal guardian(s) of the Participant, hereby grant our (my) permission for the Participant to participate fully in ALL activities, including trips away from the church premises.
The undersigned represents PVC that he/she is the natural parents or legal guardian of the above named student and the undersigned does hereby consent to the minor taking part in activities associated with PVC during the year of January 1, 2019 through December 31, 2019 with the full understanding that there is always risk of injury, illness, loss and possible consequent expense for medical, diagnostic and curative treatments and incidental loss and expense. The undersigned does for him/herself and for and on behalf of the minor assumetheriskofsuck loss, injury, expense and does hereby wholly release PVC from any responsibility or liability; and waives claim or causes of circumstance involving such child, and agrees to indemnify and hold harmless PVC for any such loss, injury, or expense; and the undersigned agrees to abide by the riles and regulations, supervision and discipline set and applied by PVC and it's agents.
MEDICAL TREATMENT PERMISSION: I authorize an adult, in whose care the minor had been entrusted, to consent to any emergency x-ray examination, anesthetic, medical, surgical, or dental diagnosis or treatment and hospital care, to be rendered to the minor under the general or special supervision and on the advise of any physician or dentist licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital or emergency care facility. The undersigned shall be liable and agrees to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child or youth pursuant to this authorization.
EARLY RETURN HOME POLICY: Should it be necessary for my child or youth to return home due to medical reasons, disciplinary action or otherwise, the undersigned shall assume all transportation costs and responsibility,
TRANSPORTATION PERSMISSION: The undersigned does also hereby give permission for my child/youth to ride in any vehicle driven by an approved and licensed ADULT chaperone while attending and participating in activities sponsored by PVC. My child/youth and I understand that SEAT BELTS MUST BE WORN AT ALL TIMES during transportation.