By submitting this form, I hereby consent to the participation of my/our child(ren) in this supervised day camp program.
The information received is confidential and is being gathered for the purposes of serving your child while in the care of Grace Chapel. Any medical information collected here serves to authorize Grace Chapel, and its staff and volunteers, to obtain medical assistance in emergencies.
While every precaution is taken for safety and good health, some sports and activities carry with them the inherent risk of personal injury beyond the risks associated with many of the recreational activities at Grace Chapel. I/we understand and accept these risks and agree that by allowing my Child to participate in these activities, he/she may be taking part in a recreational activity that presents the potential for personal injury.
I/we, the Parents or guardians named below, authorize the Pastor or one of Grace Chapel personnel to sign consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above.
I/we, named below, undertake and agree to indemnify and hold blameless Grace Chapel, its personnel, its leaders and Board from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Grace Chapel, as well as of any medical treatment authorized by the supervising individuals representing Grace Chapel. This consent and authorization is effective only when participating in or traveling to events of Grace Chapel.
I have read, understood and agree with above.