PERMISSION FOR EMERGENCY PROCEDURES:I have filled out all information on the top of this form concerning my child and hereby give my permission for (child) First Name Last Name to go to the activities listed on the top of this form. I understand that the church staff members and volunteers at these events will use their best efforts to supervise my child. However, I also understand that church staff and volunteers are not responsible for loss of personal property or bodily injury. If I or my other contacts cannot be reached at the time of an emergency or if treatment is urgent in the judgment of the church staff and medical authorities, I authorize and direct the attending church staff members to send my child (properly accompanied) to the hospital or to the most easily accessible medical facility. I understand that I will assume full responsibility for the payment of any services rendered. In the event that my child suffers any illness or accident requiring emergency hospitalization while at this event, I hereby give permission for such treatment. I also give permission to a physician to secure proper treatment for my child and to order x-rays, routine tests, and anesthesia if needed. I will not hold Mount Pleasant United Methodist Church nor its staff nor its volunteers responsible in the event of accident or loss.Parent/Guardian Signature First Name* Last Name* Date*
PERMSSION TO PARTICIPATE: I understand the emergency procedures listed above and hereby give permission for my child, First Name Last Name to attend the activities sponsored by Mount Pleasant UMC and to participate fully in such activities.Parent/Guardian Signature First Name* Last Name* Date*