Permission for Medical Care (Valid April 1, 2023-May 31, 2024):
Emergency Contact Information:
For Parent or Guardian:
I hereby authorize my student to participate and attend Chisholm Summit Community Church events between April 1, 2023-May 31, 2024. I agree that the adults in charge have my permission to solicit medical care in the best medical interest of my child. In case of accidents, I hereby release Chisholm Summit Community Church, their members, and/or their leaders from all liabilities in such case an accident should occur. I also authorize the making of photographs, motion pictures, videotapes, recordings, or other memorializing of said event and my (or my child’s) participation therein, and the publications of other use thereof. I also understand and agree that there will be a three-strike rule: Verbal warning, sit out and calling of parents. If a problem still continues, we will arrange the return of the student at the parent’s expense.
*By entering my name in the box above, I am providing my digital signature on this Form.
