Informed Consent and Acknowledgement
EPWORTH UNITED METHODIST CHURCH
1030 BURRAGE RD NE . CONCORD, NC 28025
704.786.6183 . EPWORTHNC.COM
I agree for my child(ren) to participate in the activities of Backyard Mission Camp under the supervision and guidance of adult volunteers who will adhere to the guidelines of Epworth's Safe Sanctuary policy.
To ensure volunteers and camp organizers are able to care and respond to my child(ren) should a situation arise, the information I've provided is up to date and accurate.
I willingly and knowingly assume for myself, my heirs, family members, executors, administrations and assign all risk of physical injury and sickness and emotional upset which may occur during camp and hereby agree to hold Epworth United Methodist Church, Inc., its employees, members, or trustees harmless for any liability arising out of my child(ren)'s participation in the event. I hereby give permission for photographs taken of my child/me during this event to be used in camp and/or church publicity, reports and recruitment (UNLESS OTHERWISE STATED ABOVE).
I have read, or have had read to me, all information regarding the camp my child is attending at Epworth United Methodist Church, Inc. including policies, procedures, limitations, and possibilities. My child, as named above, has permission to participate fully in all camp activities.
Confirmation
BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.