In checking the "consent" box, I agree to the following:
1. I am legally able to consent for the above named youth to participate in this event.
2. I consent to my youth, as named above, to participate in this event.
I understand that participation in this activity carries risks such as accidental injury and/or death.
3. I hereby fully release and discharge all claims that I may have for injuries or damages to me, against St. Luke’s Lutheran Church and other participating congregations, its officers, agents, servants, employees, pastor and affiliates as a result of participating in this activity.
4. I grant permission for leaders and participants of this trip to take photographs of me in connection with this activity and to use and/or publishing of the same in print and/or electronically. I agree that such photographs of me, with or without names may be used for any lawful purpose, including such purposes as publicity, illustration, promotion, and web content, including social media. – unless notice to the contrary is given in written form with this document.
5. I authorize leaders and chaperons traveling with and/or leading this event to consent to any necessary examination, anesthetic, medical diagnosis, surgery, or treatment and/or hospital care rendered to me under the general or special supervision and on the advice of any physician or surgeon licensed to practice medicine by the state or country in which they practice, during this activity.
Consent and release from Liability: St. Luke’s Lutheran Church for activities through May 2021
The child listed above has my permission to participate in all activities of St. Luke’s Lutheran Church, Waukesha, WI, through May 31, 2021 and to be transported by church vehicles or private car when necessary. I understand all events will have adult supervision. I further agree to direct my son/daughter to conform to the fullest with the directions and instructions of the leaders in charge of an event in which my child is participating. This consent and release is in effect until May 31, 2021, or until I give St. Luke’s Lutheran Church written notice to the contrary. I hereby fully release and discharge all claims that I may have for injuries or damages to my child or me, against St. Luke’s Lutheran Church, its officers, agents, servants, employees, pastor and affiliates as a result of participating in church-sponsored activities or using the facilities or equipment. This release includes granting permission to take photographs of my child(ren), my family, and me in connection with church-sponsored activities, and the use and publishing of the same in print and/or electronically. I agree that such photographs of my child(ren), my family and me, with or without names may be used for any lawful purpose, including such purposes as publicity, illustration, promotion, and web content, including social media – unless notice to the contrary is given in written form sent to the church office by mail or by email (office@stlukeslutheran.org).
I hereby give permission and authorization for medical treatment for my child listed above, or me, including but not limited to emergency surgery, and assume the responsibility of all medical bills, if any. I understand that, subject to the participant’s interests and medical condition, attempts will be made to alert the parent/legal guardian before any such necessary medical treatment is given.
