Being the parent or legal guardian of the listed student, I do consent to any x-ray, anesthetic, medical, surgical, or dental diagnosis or treatment that may be deemed necessary for my minor child. Further, I understand that all efforts will be made to contact me prior to treatment. In the event that I cannot be reached in an emergency, I give permission to the attending physician to treat my child. I further understand that the doctors, dentists, and other providers attending to my child will take all reasonable safety precautions during their care.

Further, as parent or legal guardian, I am responsible for the health care for my minor child and agree that my insurance plan is the primary plan to pay for the dental, medical, or hospital care or treatment that is given to my child. Any policy of LINCOLNWAY CHRISTIAN CHURCH will be used as the secondary coverage.

Being the parent of legal guardian of the listed student, I do give consent for my child to attend any above activities sponsored or hosted by LINCOLNWAY CHRISTIAN CHURCH and hereby give my consent for my minor child to participate in such activities.

I understand that all reasonable safety precautions will be taken by the leaders of such activities, and that the possibility of an unseen hazard does exist. I further agree not to hold LINCOLNWAY CHRISTIAN CHURCH, it’s leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by the minor listed above.

I further understand that due to disciplinary reasons (Possession of illegal substances, immoral substances, continual Breaking of event rules, physical harm to self or others), my child may be sent home by the host of the event. If this is to occur I do agree to take full responsibility of making transportation arrangements for my child. I also agree that any damages caused by my child will be taken care of by us and/or our child.

On occasion, LINCOLNWAY CHRISTIAN CHURCH take photographs or make an audio or video recording of the students and/or adults involved in church activities. Such photographs or video recordings may be used by staff to remember the activities and participants. In addition, such photographs or video may be used in LINCOLNWAY CHRISTIAN CHURCH’S publications or advertising materials and posted on Facebook to let others know about our ministry. In addition, local news organizations may hear of our activities or events, and out church may invite or allow them to photograph or record our events for news reporting on special interest features. I consent to the use of any such photographs or video of students named above to be used, distributed, or displayed as agents of the church see fit. This consent includes but is not limited: photographs, videotape, and audio recording. Furthermore, I give permission for the student to be interviewed by the news media (with an adult present) or for such photographs and other audio or video recordings to be used be the news media.