No child enrolled will be released from the program without a parent/guardian signature or that of one of the two individuals listed below if parent cannot be reached. (Note: The names that appear below must be someone 16 years or older.) 

I understand that I will be notified in the case of a medical emergency. However, in the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event that my child is injured or becomes ill.

I authorize my emergency contacts listed above to make medical care decisions on behalf of my child, if required by law or a health care provider or another adult volunteer/employee designated by the pastor. I authorize these persons to act in my place to consent to all necessary and appropriate x-ray examinations, anesthetic, medical or surgical diagnosis or treatment, and hospital care.  I understand that Faith Baptist Church will not be responsible for medical expenses incurred solely on the basis of this authorization.

I also understand that the designated adult volunteers/employees reserve the right to restrict my child from any activity that they do not feel is within the physical capabilities of my child.

Furthermore, being the parent or legal guardian of the child named above, I do hereby understand and consent to my child participating in Friday Recess activities which involve certain risks, such as injury or damage to personal property.  I hereby release and hold harmless Faith Baptist Church, its leaders, volunteers, and employees from any and all liability, claims, and causes of action arising out of or related to my child’s participation.