Is the participant taking any over the counter or prescriptions drugs?
Please list and print Clearly Please llst any Allergies to medication or foods I also understand that in the event medical intervention is necessary, every attempt will be made to contact immediately the persons listed on this form.
If cannot be reached in an emergency during the activity dates shown on this from,I give mypermission to the physician or dentist selected by the activity leader to hospitalize, to secure medical treatment and/ order an injection, anesthesia, or surgery for my child as deemed necessary. Iunderstand all reasonable safety precautions will be taken at all times by:
(The Homeschool Ministry) and its agents during the events and activities. I understand the possibility of unforeseen hazards and know there is the inherent possibility or risk. I agree not to hold, (The Homeschool Ministry), its leaders, employees and volunteers liable for damages, losses, diseases, or injuries incurred by the subject of this form.
I understand that by signing this form I/my child agree[s) to cooperate and participate fully, that l/my child will show respect for the property visited, respect for neighbor, that I/my child will show respect for the law and practice safety skills at all times. By failing to meet this code of conduct, l/my child am/are aware that appropriate action may be taken and arrangements may be made for immediate removal from the event.
(Use another sheet if necessary)
I hereby authorize the making of photographs, motion pictures, videotapes, recording, or other memorializing of said event and my child's participation therein, and the publication and duplication or other use thereof. I hereby waive any rights to compensation or any right that I otherwise might have to limit if to control such making or use. By checking this box, I DO NOT authorize any photos, videotapes or recordings of my child.