Parent/Guardian Information:
(Please provide a copy of medical insurance card.)
Does your student have any of the following medical concerns? If you answer YES to any, please give detailed description of concern in the space below for each student.
Over-the-counter Medication Permission:
Do you give permission for your child to be given over-the-counter medication as needed and as directed on the label, to treat non-emergency medical conditions while at a church-sponsored event?
Are there any over-the-counter medications that your child can NOT have?
Medical Treatment Permission:
I, the undersigned, also give permission for the employees and sponsors of the Parkview church of Christ, to seek medical care for the above mentioned child(ren), in the event that it becomes necessary. The decision to seek medical care will be at the discretion of the employees/sponsors of the Parkview church of Christ, and the medical professionals involved. I, the undersigned, understand that every effort will be made to contact parent(s)/guardian(s) in the event medical care is needed. I, the undersigned, understand that it is my responsibility to pay for the costs of any medical care received by the above mentioned child(ren). Where applicable, medical insurance has been provided and will be used.
I, the undersigned, do give permission for my student(s) to attend and participate in activities sponsored by the Parkview church of Christ.
Along with permission, I, the undersigned, also release the Parkview church of Christ, its employees and sponsors, from any and all liabilities regarding the care and safety of the above mentioned child(ren). I grant my permission for the above mentioned child(ren) to participate fully in children/youth ministry activities and child care, including trips away from church premises. Furthermore, I, the undersigned, on the behalf of my minor(s) participant(s), hereby assume all risk of accidental personal injury, sickness, death, damage and expenses as a result of participation in recreation and work activities involved therein.
Transportation Permission:
I, the undersigned, give my consent for the student(s) identified above to be transported by an approved and licensed adult chaperone in any vehicle for any event sponsored by Parkview church Christ, and will assume all liability for my/their participation in this activity/ event and injury that may result during the transport or at the event/ activity.
Early Return Home Policy:
Should it be necessary for my child or youth to return home due to medical reasons, disciplinary action or otherwise, the undersigned shall assume all transportation costs and responsibility.
I, the undersigned, give permission for my child to be photographed and or videotaped during church sponsored activities. By signing below, I give permission for my child's (children's) image, in its original or edited form, to appear in print or digital publications promoting the church's activities. I also understand that once my child(ren)'s image(s) are posted on the church's website or social media accounts, the image can be downloaded by any computer user, anywhere in the world. Therefore, I agree to indemnify and hold harmless the church, its trustees, ministers, elders, deacons, its members and designees from any claims arising out of the use of said images and videos.
I, the undersigned acknowledge the contagious nature of COVID-19 and that my child(ren) and I may be exposed to or infected by COVID-19 by participating in church-sponsored functions ant that such exposure or infection may result in personal injury, illness, permanent disability, and death.
Your signature below indicates agreement to all waiver items listed above and statements afore mentioned in this form.
