• Minor Mission Participation Agreement (2019-2020)

    Please fill out the attached form and sign where prompted. This form MUST be received by a Ministry Leader of Spring Hills Baptist Church (Spring Hills) before the minor is listed on this form may participate in any event sponsored by Spring Hills. This Participation Agreement Form covers the term of March 1, 2019 - May 31, 2020.
  • Personal Information

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  • Preferred Emergency Contact Information

  • Secondary Emergency Contact Information

    In the case that the Primary Emergency contact cannot be reached
  • Permissions

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  • AUTHORIZATION TO CONSENT TO MEDICAL TREATMENT:

    The undersigned consents:

    1. The administration of any treatment deemed necessary by:

  • OR in the event the appropriate specified practitioner is NOT available, by another licenced physician or dentist:

    2. The transfer of minor to preferred hospital or any hospital reasonably accessible.

  • 3. This authorization does not cover major surgery unless the medical opinions of
    two other licensed physicans or dentists concurring in the necessity for such surgery are obtained in writing prior to the performance of such surgery.

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