JULY 21-23 2023
Activity Permission, Release, & Medical Power of Attorney
1.I,{parentguardianNames}the lawful parent or guardian of {campersName}{last7}, give permission for my child to participate in the activity of Foursquare Kids camp located at Warm Beach Camp, 20800 Marine Dr, Stanwood, WA 98292 and release, from all liability and indemnify the International Church of the Foursquare Gospel: MARYSVILLE FOURSQUARE CHURCH, and its directors, officers, council, agents, representatives,volunteers, and employees ("M4CHURCH") from any and all liability, claims, judgments, cost or expense, including attorney fees, arising out of any damage, injury or illness incurred or caused by my child while participating in or traveling to or from the activity, or otherwise in camp custody. I understand the risks in these activities, including the possibility of unforeseen hazards, serious injury or death. I certify my child is able to participate in the activity.
2.I agree to instruct my child to cooperate with the camp and its representatives in charge of the activity and understand my child may be prohibited from participating and or sent home for any failure to follow the rules established by the MARYSVILLE FOURSQUARE CHURCH and Warm Beach Camp.
3. I appoint MARYSVILLE FOURSQUARE CHURCH representatives who are acting as leaders, or designated by such leaders as my attorney in fact to act for me in my name and my behalf, in any way that I could act if were personally present with respect to the following matters if any injury, illness or medical emergency occurs during the activity, related travel or while my child is in camp custody.
A. To give any and all consents and authorization to any physician, dentist, hospital or other persons or institutions pertaining to any emergency actions as our medical attorney in fact shall deem necessary or appropriate for the best interest of the child.
B. I understand the M4CHURCH will make a reasonable attempt to contact me as soon as possible in the event of a medical emergency involving my child.
4. I agree that the M4CHURCH may use my child's and or my own name, voice, portrait, photograph or image for promotional website, office or any other district related purpose. These may be used in any broadcast, telecast, digital or print medium, including video images, photographs, pictures or renderings, audio recordings, or other likenesses, in combination or alone.