I- Authorization of Consent to Participation of Minor:
(I) (we), the undersigned, parent(s) of my child, a minor, do hereby authorize my child to participate in events held by Peace United Methodist Church in San Jose (PUMC) unless otherwise communicated by myself to PUMC and its ministry leaders. It is understood that this is in effect for the length of time my child is enrolled in the Vacation Bible School (VBS) 2019 program.
II- Authorization of Consent to Treatment of Minor:
(I) (we), the undersigned, parent(s) of my child, a minor, do hereby authorize Peace United Methodist Church, its ministry leaders as agent (s) for the undersigned to consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is to be rendered under the general or specific supervision of, any physician and surgeon licensed under the provision of the Medical Practice Act, whether such diagnosis or treatment is rendered at the office of said physician or at a hospital. It is understood that this is in effect for the length of time my child is enrolled in the VBS 2019 Program.
It is understood that this authorization is given in advance of any specific diagnosis, treatment, or hospital care being required, but is given to provide authority and power on the part of our aforesaid agent(s) to give specific consent to any and all such diagnosis treatment or hospital care which the aforementioned physician in the exercise of his best judgment may deem advisable.
This authorization is given pursuant Section 25:8 of the Civil Code of California. This authorization shall remain effective through the above named minor's attendance of the VBS 2019 Program, unless sooner revoked in writing delivered to said agent(s).
III- Authorization of Consent to Photographic Use of Minor:
As his/her parent(s) hereby grant, voluntarily and with full understanding, to Vacation Bible School ministry, a ministry of Peace United Methodist Church, a license to the following:
1. Use and storage of my child’s name and image, by means of digital or film photography, video photography, audio recording or other documentation, with respect to any activity of PUMC during the time my child is enrolled in the VBS 2019 program.
2. Use of any stored data including my child’s name and image in printed publications of PUMC.
3. Use of any stored data including my child’s name and image in electronic publications of PUMC.
4. Use of any stored data including my child’s name and image in any Web site created by or for PUMC for its sole benefit.
IV-Release of Peace United Methodist Church:
As his/her parent(s) shall indemnify, hold free and harmless, assume liability for, and defend the Peace United Methodist Church and it's affiliate corporations, its agents, servants, employees, officers and /or directors from any other sums or liability, assertion of liability, or any claim or action founded thereon, arising or alleged to have arisen out of my child use of real or personal property belonging to the PUMC and its affiliated corporations, its agents, servants, employees, officers, and directors, or action or omission by my child. It is understood that this is in effect for the length of time my child is enrolled in the Vacation Bible School 2019 Program.
The parent is responsible for contacting PUMC if he/she does not agree with or have changed his/her mind regarding the terms provided on the VBS 2019 waiver and release agreement.