I, the undersigned, certify that I am the parent or legal guardian of the youth listed above (hereafter the "minor child").
I hereby give my consent to have my minor child participate Church at the Crossing’s Youth Ministry activities during the 2016-2017 school year.
I recognize that there are risks involved in participating in this activity and hereby assume all risk of injury, harm, damage, or death to my minor child in connection with his/her transportation to and from and participation in the activity.
To the fullest extent permitted by law, I release Church at the Crossing, its trustees, officers, directors, employees, agents and representatives from any injury, harm, damage or death which may occur to my minor child while participating in the activity and agree to save and hold harmless Church at the Crossing, its trustees, officers, directors, employees, agents and representatives from any claims arising out of my child’s participation in the activity.
Further, being the parent or legal guardian of the minor child, I do consent to any medical, surgical, x-ray, anesthetic, or dental treatment that may be deemed necessary for my minor child. I understand that efforts will be made to contact me prior to treatment but, in the event I cannot be reached in such 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. As parent or legal guardian, I understand that 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 the medical, dental or hospital care or treatment that is given to my child. Any insurance policy of the church will be used as secondary coverage.