In the event that I am injured while participating in New Year Retreat, January 12th–14th 2024, I do hereby authorize and consent to any x-ray, examination, anesthetic, medical, or surgical diagnosis rendered under general or special supervision of any licensed medical staff member under the provisions of the Medicine Practice Act.
It is understood that this authorization is given in advance of any specific diagnosis or treatment being required, but it is given to provide authority and power to render care which the aforementioned physician, in his or her best judgment, may deem advisable.
It is understood that effort shall be made to contact, the undersigned, prior to rendering treatment, but that any of the above treatment will not be withheld if no one can be reached. This authorization is given pursuant to the provisions of section 25.8 of the Civil Code of California.
I understand the retreat setting and nature of this event and do hereby release Saddleback Valley Community Church, or any of its staff or representatives, volunteers or the like, for accidents or injury sustained in conjunction with CM’s 2024 New Year Retreat in San Juan Capistrano, CA.