****This must be filled out separately for each child***

I hereby authorize the participation of the named child in activities at and/or associated with Lakeside Community Chapel (LCC) from September 2025 through May 2026 in relation to the AWANA ministry. In consideration of LCC providing these activities, I, on behalf of myself and the other parents/guardians of the minor, do hereby release LCC, its officers, employees, agents, and members of the Board of Elders from all claims and causes of action by any injury which may be sustained as a result of these activities. I agree to direct my child to cooperate with and to conform to directions and instructions of personnel of the organization in charge of these

If I cannot be reached within a reasonable period of time, as determined by the adult ministry sponsor in charge, I hereby give my permission to the physician, nurse, or dentist selected by LCC to secure medical or dental aid as required for illness or injury under physicians' orders, including transportation to and from the necessary facilities. As a participant, I understand LCC is not obliged to carry any insurance to cover those medical and/or dental expenses. If such insurance is carried, coverage will be provided only for expenses in excess of the limits of the participant's insurance. I understand that my personal insurance is my primary coverage.