PARENTAL AUTHORIZATION

LIABILITY RELEASE: In consideration of Crossroads Community Church allowing the above child(ren) to participate in Kids4Christ activities, we (I), the undersigned, do hereby release, forever discharge and agree to hold harmless Crossroads Community Church, its directors, employees, volunteers and agents (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the above child(ren) while involved in Kids4Christ.

Furthermore, we (I) [and on behalf of our (my) minor child(s)] hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in activities involved therein. As well as releasing the child(ren) if necessary for transportation to and from the Kids4Christ location. We(I), the undersigned, do hereby release, forever discharge and agree to hold harmless Crossroads Community Church, directors, employees, volunteers and agents from any and all liability, claims or demands for accidental personal injury in the process of transportation.

MEDICAL TREATMENT PERMISSION: We (I) authorize an adult, in whose care the minor has been entrusted, to consent to any emergency x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care, to be rendered to the minor under the general or special supervision and on the advice of any physician or dentist licensed on the medical staff of a licensed hospital or emergency care facility. The undersigned shall be liable and agree(s) to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child or youth pursuant to this authorization.

PHOTO/PICTURE PERMISSION: I (we) give my (our) consent to Crossroads Community Church to use photo or video images taken of my (our) child(ren) in church brochures, advertisements for the church, on the website, in social media, and in other church publications as they see fit. I agree to hold harmless Crossroads Community Church from any liability which may result from the use of said picture(s). This form will apply throughout my (our) child(ren)’s tenure at Crossroads Community Church’s Kids4Christ.**None of the photos to be taken will be for personal use.

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