As parent(s), legal guardian(s), or custodian(s) or this minor, I/we permit him/her to participate in all officially supervised Clear Lake United Methodist Church (CLUMC) Children’s Ministry programs and activities for which he/she is registered or participates (when no registration is required).  I/we knowingly release, absolve, indemnify, and hold harmless CLUMC, its Members, Trustees, Administrative Board, Committees and Staff, as well as the organizers, sponsors, workers and all other acting on behalf of CLUMC or its programs and activities, from all claims that might result from any accident, personal injury, illness or death to the minor named above in connection with any such program or activity.

In the event I/we cannot be reached to make arrangements for emergency medical attention I/we authorize the designated event supervisor to administer or authorize the administration of emergency medical treatment in case of illness or injury to the minor named above.

 

The undersigned does herby give permission for our (my) child to attend and participate in the ministries of Clear Lake United Methodist Church (CLUMC)

We (I) authorize an adult, in whose care the minor has been entrusted, to consent to any X-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment, and hospital care, to be rendered to the minor under the general or special supervision and on the advice of any physician or dentist licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at the said hospital.

The undersigned shall be liable and agree to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child pursuant to this authorization.  Furthermore, we (I) do hereby release, forever discharge and agree to hold harmless CLUMC and the directors thereof from any and all liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the child-participant that occur while said child is participating in the above-described trip or activity. 

Furthermore, we (I) hereby assume all risk of personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein. 

Further, authorization and permission is hereby given to said church to furnish any necessary food and lodging for this participant. 

The undersigned further hereby agree to hold harmless and indemnify said church, its directors, employees and agents, for any liability sustained by said church as the result of the negligent, willful or intentional acts of said participant, including expenses incurred attendant thereto. 

Should it be necessary for our (my) child to return home due to medical reasons, discipline action or otherwise, the undersigned shall assume all transportation cost. 

The undersigned does also hereby give permission for our (my) child to ride in any vehicle designated by the adult in whose care the minor has been entrusted while attending and participating in activities sponsored by CLUMC.

 

Media Release

CLUMC uses a variety of resources to publicize and celebrate church events and news. By registering your child you do not object to a photograph or other electronic image of your child on the CLUMC website, newspaper, marketing brochures, publications, newsletters, or CLUMC promotional videos formally prepared for use both inside and outside the church.