Permission to Treat/Transport
For liability purposes, we require a completed consent form on your child EACH CALENDAR YEAR. It is not necessary to fill one out for every individual event he/she attends; however, your child must have one on file prior to attending his/her first event of the year.
PARENT/GUARDIAN INFORMATION
SECONDARY EMERGENCY CONTACT INFORMATION
Please supply ALL of the following information.
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 CrossRoads Baptist 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 liability for any injury, loss or damage to person or property that may occur during the course of my/our child’s involvement. If 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 physician and/or hospital personnel designated by CrossRoads Baptist 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 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 expense should they become ill or if deemed necessary by the student ministries staff member. I/we agree to submit updated insurance information if our provider/coverage changes. I/we give permission to include my/our student in any videos and/or photographs taken during my student’s involvement. I/we agree that a photocopy of this document shall be a legally binding document.