Praise Kids Permission Form
Hooties Corn Maze
Tuesday, October 24, 2017
3 - 5:45 PM
The Kids will be picked up from school and will return to Cedar Street Baptist Church at 5:45 PM.
I/We the undersigned have legal custody of the child named below, a minor, and have given our consent for him/her to attend events being organized by the church. I/We understand that there are inherent risks involved in any ministry or athletic event, and I/We hereby release the church, its pastors, employees, agents, and volunteer workers from any and all liability for injury, loss, or damage to person or property that my occur during the course of my/our child’s involvements. In the event that he/she is injured and requires the attention of a doctor, I/We consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by the church. I/We agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I/We also acknowledge that we 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 provider, further, I/We agree to bring my/our child home at my/our own expense should they become ill or if deemed necessary by the Leader or any volunteer.
Please Fill in the Below Section Completely
All Fields are Necessary to Submit
Parent or Guardian
Emergency Contact Name
Other than Parent or Guardian
Parent or Guardian Number
Emergency Contact Number
Any Special Sicknesses or Allergies we should know about?
If Yes, please list here.
Dennie K. Lanier
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