I, as a parent/legal guardian of the minor, understand that my child will be attending Project Timothy at Christ The King Vineyard in North Olmsted, OH. I understand that during this time he/she will be accompanied by volunteers from this and other Vineyards in our region under the direction of staff and volunteers from the Great Lakes Region of the Vineyard, Quest Vineyard Church, and Christ The King Vineyard Church.
I hereby release Quest Vineyard Church, Christ The King Vineyard Church, as well as any other Vineyard church that provides volunteers staff, and/or any sponsors of the event, from responsibility and liability for any loss, injury, or illness that my child may sustain during any activity or event while at Project Timothy. In the event of an emergency, I understand that every reasonable effort to contact me will be made. In the event that I am unable to be contacted, I hereby authorize an adult leader, as agent for me, to consent to any medical, dental, or surgical diagnosis; X-ray examination; and/or hospital care advised and supervised by a physician, surgeon, or dentist (as appropriate) licensed to practice under the laws of the state or province where the services are rendered, either at the doctor's office or in any hospital.
In the event treatment is required from a physician and/or hospital personnel designated by the church, I agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I also acknowledge that we will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by a health insurance provider. Further, I affirm that the health insurance information provided below is accurate at this date and will, to the best of my knowledge, still be in force for the student named above and it is my responsibility to ensure that the information is up to date. I also agree to provide transportation at my own expense should they become ill or if it is deemed necessary by the student ministry staff member.