I, the undersigned parent(s) or guardian(s), hereby consent to my child/children,__________________________________________________________________who is/are________________________ years of age, participating in the activities connected with: ________________________________; an activity sponsored by First Baptist Church on the following date(s): __________________________________________________ I understand that my child will meet at ______________________________ at _____________ a.m./p.m. and return at _____________ a.m./p.m. and that the transportation used will consist of ______________________ ____________________________________________.
I understand that this activity will include the following: _______________________________________________________________
I certify that my child is able to participate in any and all of these activities. If my child has medical conditions which may be relevant to a physician in the event of an emergency, I have listed them below. In the event that an emergency occurs, I may be reached at the telephone number listed below. If I cannot be reached within a reasonable period of time, as determined by church officials, I hereby authorize the church or the adult sponsor_________________________________ to make emergency medical decisions for my child. If there are any activities that I do not want my child to be involved in, I have listed them below.
I UNDERSTAND AND HEREBY AGREE TO ASSUME ALL OF THE RISKS WHICH MAY BE ENCOUNTERED ON SAID ACTIVITIES, INCLUDING ACTIVITIES PRELIMINARY AND SUBSEQUENT THERETO. I do, for myself and for my child, heirs and assigns, hereby irrevocably and unconditionally release, acquit and forever discharge First Baptist Church and its agents, employees, and volunteers from any and all liability, actions, causes of actions, claims, expenses, obligations and damages of any nature whatsoever, which I now have or which may arise in the future, in connection with my child's participation in the described activity or in any other associated activities including, but not limit to, any injury to my child or property, even injury resulting in death. I expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as permitted by the law of the State of Utah and that if any portion hereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto.
I further state that I HAVE CAREFULLY READ AND UNDERSTAND THE FOREGOING RELEASE AND KNOW THE CONTENTS HEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. I understand that this is a legally binding agreement.
