Release of Liability, Consent for Medical Treatment & Transportation

If you have already filled out a Friendship liablility waiver for any event in 2022, you can leave the emergency information section blank and scroll down to the parent signature section at the bottom.

In an emergency when parent/guardian cannot be reached or is not applicable, please contact the following:

I hereby willingly consent to havy my child (state above) attend events and activities operated by Friendship Baptist Church. In the event that my child is injured while attending activities and requires the attention of a doctor, I consent to any reasonable medical treatment as deemed necessary by a physician. In the event treatment is called for, which a physician and/or hospital personnel refuses to administer without my consent, I herby authorize the lead adult of the group, or a member of the Friendship Baptist Church leadership to give such consent for me.
In the event it becomes necessary for that person to give consent for me, I agree to hold such person free and harmless of any claims, demands, or suits or damages arising from the giving of such consent so long as the treatment is administered by or under the supervision of a physician. I also acknowledge that I will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance carrier.
By signing this form, I acknowledge that I am fully aware of the COVID-19 virus and the risk of exposure. I voluntarily and knowingly assume the risk of any and all consequences related to COVID-19 and freely consent to allow my child to participate in this event or activity.
In signing this form, I also agree to fully and forever release, discharge, indemnify, and hold harmless Friendship Baptist Church, its agents, servants, and employees from any and all claims, demands, damages, rights of action or causes of action, present or future whether the same be known, anticipated or unanticipated, resulting or arising out of participation in this event or activity.
Further, I affirm that the health insurance information provided is accurate at this date and will, to the best of my knowledge, still be in force at the time of the activity.
Parents/Guardians Signature *
After you submit the form you will have an option to pay either the full balance ($350) or deposit online ($50). You may also pay via check or cash.
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