PARENTAL CONSENT AND WAIVER /Please have this form printed and signed on June 16th for drop off.
Roseland Global Methodist Church (Roseland Church, Inc.) 12962 Roseland Road, Sebastian, FL 32958
Name of child/youth:
Grade:
Age:
Address:
As the parent (or legal guardian) of:
Please print Child/Youth's Name
I understand that my child/youth will be participating in a number of activities at Roseland GMC (the "Church"), which carry with them a certain degree of risk. Some of the activities are in connection with the use of a bounce house and/or slide and/or other activities which the Church may offer. I consent for my child to participate in these activities.
I represent that my child/youth is physically fit and has the necessary skills to safely participate in these activities.
MEDICAL TREATMENT AUTHORIZATION. It is my understanding that the Church (including any volunteers or staff) will attempt to notify me in case of a medical emergency involving my child/youth. If the Church (including any volunteers or staff) cannot reach me, then I authorize the Church (including any volunteers or staff) to call 911, and I give my permission to the doctor or other health-care professional, to provide the medical services he or she may deem necessary. I will pay for any medical expenses so incurred and hereby waive any claims I may have on the Church (including any volunteers or staff).
Allergies or other health considerations:
Signature of Parent or Guardian
Print Name:
Phone Number:
Date: