Medication & Photo/Web Release (Please Check box if you agree/initial) and Indemnity and Contract Agreement
I understand that the staff and volunteers of Adventure Youth & Adventure of Faith Church are not medical professionals. They are not responsible for the timely distribution of my student's medication. While they will store medicine and provide reminders to take it, my student is ultimately responsible for taking his/her own medication in a timely manner.
I understand that promotional pictures (individual and group) have been/will be taken during these events. I give permsision for my son's/daughter's picture to be used for the promotion materials (newsletters, webpage, promotional signs, etc) in highlighting the event.
I will not hold or attempt to hold ADVENTURE OF FAITH CHURCH liable for loss, damage or injury to person or property caused by any act or neglect of other persons, or caused any manner other than the willful negligent act of ADVENTURE OF FAITH CHURCH, it's volunteers and employees and will indemnify and hold ADVENTURE OF FAITH harmless in any liability for damage or claims against ADVENTURE OF FAITH CHURCH arising out of or in any way related to such loss, damge or injury.
I release ADVENTURE OF FAITH CHURCH, including its trustees, employees and agents from my student's physcial injury, including death, or illness while attending or participating in the event(s) or activities. I will assume the risk associated therewith, whether known or unknown to me at this time. THis release is also intended to include all claims of my family estate, heirs, personal representatives or assigns.
Authorization of Treatment: I hereby give permission to the medical personnel selected by ADVENTURE OF FAITH CHURCH or its employees to secure and administer treatment and to maintain and/or release any medical records necessary for insurance purposes as outlined under the HIPAA regulation and to provide or arrange necessary related transportation for the above named person.
I verify that my child is in good health and is capable of participating in strenguous activities, and when necessary, will take his/her activities to those within the bounds of his/her physical health. I recognize that any medical treatment that is provided to my child while attending this event will be paid for by me or my medical insurance company.
