By signing at the end of the form and initialing here: initials* I hereby give written permission for my child(ren) to attend and participate in all Children's Ministry activities at Memorial Baptist Church. As a parent/guardian, I do hereby authorize the treatment of my child(ren) by a qualified and licensed medical doctor in an emergency which, in the opinion of the attending physician, may endanger his/her life, care, cause disfigurements, physical impairments, or undue discomfort if delayed. The authority is granted only after a reasonable effort has been made to reach me.
Memorial Baptist Church regularly takes photographs or makes audio/video recordings of children and/or adults involved in church activities. By signing at the end of the form and initialing here: initials* I understand that by participating, my child may appear in such photographs and audio/visual recordings which may be used in Memorial Baptist Church's publications or advertising materials to let others know about the church's ministries.If I wish to opt out, I will personally contact the Children's Minister Rachael Gomez at email@example.com so that special accommodations can be made.
By signing at the end of the form and initialing here: initials* I understand, for safety purposes, that I must present the security claim tag assigned to me or a digital image of the tag in order to obtain my child(ren) from Vacation Bible School once they are checked in.
By signing below and initialing here: initials*I, on behalf of myself and my dependents, hereby assume all the risks of requesting this service, including by way of example and not limitation, any risks that may arise from contracting the COVID-19 virus from this service provider, gross negligence or carelessness on the part of the service provider, and release my service provider from any and all liability from any medical condition, viruses, of the service provider and contracting such viruses from the service provider. This waiver and release of liability covers any negligence or gross negligence in relation to exposing me or my dependents to the COVID-19 virus and understand the potential for infection despite all CDC-recommended precautions that will be taken. I understand utilization of services is completely voluntary, and I assume all the risks as a result. I am responsible for determining whether a physical or medical examination should be undertaken before I or my dependents participate in the services being provided, and I will abide by any determination, limitation, or recommendation that may be issued by my medical or health care provider. Before, during, and after the services, I am solely responsible for determining my and my dependent’s health and physical status and whether I or my dependents can or should discontinue my participation in the services, or take other actions, to protect my own, and my dependents, health or safety. Service provider assumes no duty to me or my dependents to ensure my physical or medical ability to participate in the services, whether before, during, or after the services.I acknowledge that this waiver and release of liability form will govern my actions and responsibilities at said services, activity, or event. In consideration of providing services to me and/or my dependents, I hereby take action for myself, dependents, my executors, administrators, heirs, next of kin, successors, and assigns as follow:(A) I waive, release and discharge from and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this event, the following entities or persons: service provider and its directors, officers, employees, representatives, employee, and agents: (B) I indemnify, hold harmless, and promise not to sue the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this service, activity, or event, whether caused by the negligence of release or otherwise. My and my dependent’s participation in the services is voluntary.I acknowledge that this service provider and its directors, officers, employees, representatives, and agents are not responsible for the contamination, errors, omissions, acts, or failures to act of any party or entity conducting in providing the services. The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.