I/we hereby authorize any hospital, clinic, physician, doctor, nurse, or technician to furnish my child, named above, any medical care and treatment necessary as a result of any injuries sustained or other emergency medical care treatment as the circumstances require during all onsite activities and events (referred to as “events”), including while being transported from and back to the church and while at the place of destination. I/we hereby authorize representatives of Palma Ceia Presbyterian Church (PCPC) to retain or acquire said medical care and treatment on my behalf if I cannot be reached by phone or there is not time or opportunity to make such a call. I/we also authorize PCPC to provide emergency transportation for my child. I/we agree to be responsible for payment of any and all medical treatment, services, or transportation rendered. I/we understand that PCPC does not provide any guarantee of medical confidentiality or transportation of my/our child to a specific physician or medical care facility.
I/ we do hereby agree, for my child and my child’s heirs, parents, guardians, representatives, successors, and assigns, to fully release, discharge, hold harmless, indemnify, and defend PCPC, its officers, administrators, trustees, staff, representatives, employees, contractors, volunteers, agents, affiliates, and insurers (“Released Individuals”) from and against any and all injuries, damages, claims, actions, expenses, liability, or losses of any kind to, or caused by, me or my child arising out of or in any way related to obtaining or providing medical treatment or emergency transportation for my child. I acknowledge that this release shall waive all rights by me, my child, or anyone acting on our behalf, individually or collectively, to pursue relief for injuries, damages, or losses against the Released Individuals in any forum and under any theory; including, but not limited to, theories of contract and tort. I further agree that this release unequivocally is intended to waive all claims against the Released Individuals due to any cause, including their own negligence or gross negligence. This release is effective as of the date written below and is to be construed according to the law of Florida. This release may be modified only in a writing signed by both me and an authorized representative of PCPC. I have executed this release freely and voluntarily and without duress or coercion of any kind. I further represent that I have been given adequate time to review this release and that I completely understand the language used in it as well as the rights waived by my signature. If any portion of this release is found invalid or overbroad by a court of competent jurisdiction, I agree that the remaining portions shall continue in full effect, or that the release will be modified to the minimum extent required to ensure validity, as appropriate.
VBS PERMISSION TO PHOTOGRAPH / VIDEO
I grant permission to PCPC to photograph or videotape my child at VBS and to publish, reproduce, and distribute such photos or videos in church publications, social media, and understand if declined, my child will not be able to be in the closing program on Friday.
CHILD COVENANT (for your child)
I promise to be a faithful member of the community gathered. This means that I'll be respectful to all adults and children, listen to all instructions given, and be excited to be part of our activities. I understand that I am representing my church, my family, and God, and if I do not act within event expectations and in a respectful way at any event, my parents may be called, and I may not be able to remain at the event.