Children's Ministry Registration 2021-2022
For more information contact Becky Diaz. For fields that do not apply, please type N/A.
Permission/Refusal to Publish Media of Student
St. Michael’s by-the-Sea Episcopal Church, its employees or agents, on occasion take photographs, videotape, or digital recordings of the people participating in parish events, to use in any and all media exclusively for the purpose of 1) reporting on the church’s activities through the church printed and electronic newsletters, web site, social media, and press releases; and 2) to promote future activities to be held at or by St. Michael’s by-the-Sea.
I hereby release the Episcopal Diocese of San Diego, and St. Michael’s by-the-Sea Episcopal Church, its directors, officers, employees and volunteers from responsibility and liability for any injury or illness that my child/youth, OR I as an adult participant may sustain during this activity. In the event of an emergency, I hereby authorize an adult leader of this activity, as agent for me, to consent to any x-ray examination, medical, dental or surgical diagnosis, treatment and hospital care advised and supervised by a physician, surgeon, or dentist (as appropriate), licensed to practice under the laws of the state where the services are rendered, either at a doctor’s office or in any hospital. I expect to be contacted as soon as possible. The medical information stated above is true and accurate to the best of my knowledge and belief.