2019 Jamestown Reformed Church VBS Registration

The undersigned does hereby give permission for our (my) child(ren) listed on this form to attend and participate in Jamestown Reformed Church children or youth ministry activities, events, and retreats during the period of June 2018 – August 2019. In consideration of Jamestown Reformed Church allowing Participant(s) to participate in children or youth ministry activities we (I) the undersigned, do hereby release, forever discharge and agree to hold harmless Jamestown Reformed Church, its directors, employees, volunteers and agents (collectively here in 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 Participant while involved in the children/youth activities. We (I) the parent(s) or legal guardian(s) of this Participant hereby grant our (my) permission for the Participant to participate fully in child/youth ministry activities, including trips away from the church premises. Furthermore, we (I) [on behalf of our (my) minor Participant(s)] hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein. Further, authorization and permission is hereby given to said Church to furnish any necessary transportation (within the limitations of church insurance and the law), food and lodging for this Participant. The undersigned further hereby agree to hold harmless and indemnify said Church for any liability sustained by said Church as a result of the negligent, willful or intentional acts of said Participant, including expenses incurred attendant thereto. We (I) authorize an adult, in whose care of the minor has been entrusted, to consent to an emergency x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment at a licensed hospital or emergency care facility. The undersigned shall be liable and agrees 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. We (I) give permission for photos or electronic images of our (my) child or youth to be used in the church publications, multimedia presentations, in future promotion, and on the Jamestown Reformed Church web site.

2019 Jamestown Reformed Church VBS Registration

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