Student Permission Slip

October 13 // 5-7pm | Please fill out this form and click submit.
ONE FORM PER STUDENT
 
 
 
 
 
 
 
Please select one option.
Please select one option.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

This consent form gives permission to seek whatever medical attention is deemed necessary, and releases the Church and its staff of any liability against personal losses of the named child. I/We the undersigned have legal custody of the student named above, 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 any injury, loss, or damage to person or property that may occur during the course of my/our child’s involvement. 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 MFA 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 affirm that the health insurance information provided above is accurate at this date and will, to the best of my/our knowledge, still be in force for the student named above. I/we also agree to bring my/our child home at my/our own expense should they become ill or if deemed necessary by the student ministries staff member. From time to time, photos will be taken of students, student activities, etc. Midland First Assembly reserves the right to use these photos for news releases, website, video and slide presentations, marketing purposes, etc. We also may allow members of the media to take pictures of students for publication. By signing below I give permission for my child to be photographed or videoed for use in print, web and other such purposes.

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Description

October 13 // 5-7pm
Please fill out this form and click submit.