This form is for all under 18 for activities at or with Rosemont Baptist Church (one form per person) and will be kept on file in the office and a copy will be given to the responsible adult who will be directing each event not held on the Campus of Rosemont Baptist Church. Each event will have a separate permission slip to be signed by the parent or guardian.
If necessary, describe in detail the nature and severity of any physical and/or psychological ailment, illness, limitation, disability, or condition to which your child is subject and to which we should be aware, and what, if any action of protection is required on account thereof. Submit this notification in writing and attach to this form. Include names of medications and dosages that must be taken. All information is confidential.
This consent form gives permission to seek whatever medical attention may be deemed necessary, and releases Rosemont Baptist Church, and its adult leaders of any liability against personal injury or losses of named child. I understand that there are inherent risks involved with any event, and hereby release the Church, its pastor, employees, and volunteer workers from any and all liability for any injury, loss, or damage to person or property that may occur during the course of my child’s involvement. In the event that he/she is injured and requires attention of a doctor, I consent to any reasonable medical treatment deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel, I agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I also acknowledge that I 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.