MEDICAL RELEASE
I, being the parent or legal guardian of the child named above have been informed of the above activity sponsored by St. John's Lutheran Church and School, hereby give my consent for my minor child to participate in this activity. I understand that all reasonable safety precaustions will be taken by the leaders of this activity, and that the possibility of an unforeseen hazard does exist. I further agree not to hold St. John's Lutheran Church and School, its leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by the minor listed on this form.
Being the parent or legal guardian, I do consent to any X-Ray, anesthetic, medical, surgical, or dental diagnosis or treatment that may be deemed necessary for my minor child. Further, I understand that all efforts will be made to contact me prior to treatment. In the event I cannot be reached in an emergency, I give permission to the activity leader to make the decisions necessary for treatment. Should there be no activity leader available, I give permission to the attending physician to treat my minor child. I further understand that the doctors, dentists, and other providers attending to my child will take all reasonable safety precautions during their care. Further, as a parent or legal guardian, I am responsible for the health care decisions of my minor child and agree that my insurance plan is the primary plan to pay for dental, medical, or hospital care or treatment that is given to my child.