Liability Release Form
I certify that my son/daughter has no injury that would limit his/her participation in the clinic. I hereby release, exonerate and discharge the clinic and their employees from any and all actions or causes of actions, known or unknown, from any injuries incurred in the clinic. The below signed parent/guardian does hereby delegate to the Bishop Fenwick Clinic, its employees or agents, the authority to seek, obtain and approve medical care and treatment for the below named minor, which in their judgement is necessary for the health and well-being of said minor during his/her attendance at the Bishop Fenwick Clinic. Furthermore, I agree to hold the Bishop Fenwick Clinic, its employees or agents, harmless from any liability arising out of any faith actions in seeking and obtaining medical care and treatment for the below named minor. All costs incurred are the responsibility of the parent/guardian.