First Reformed Church of Zeeland Medical Release & Permission Form

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First Reformed Church
148 E Central Ave
Zeeland, MI 49464
616-772-9129
 
 
 
 
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Medical History

 
 
 
 
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Photo Release

Do you give permission for First Reformed Church of Zeeland to use, reproduce, and/or distribute photographs, films, video, and sound recordings of your child without compensation or approval rights, for use in both printed and website materials created for purposes of promoting First Reformed Church of Zeeland.
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has my permission to attend all ministry activities sponsored by First Reformed Church.

This consenst form gives permission to seek whatever medical attention is deemed necessary and releases the Church and its staff of any liability aganist personal losses of named child.



I/We the undersigned have legal custody of the student named above, a minor, and have given our consent for him/her to attend the events being organized by the Church. I/We understand that there are inherent risks involved in any ministry or athletic event, and I/we hereby release the Church, its pastors, employees, agents, 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/our child's involvement. In the event that he/she is injured and requires the attention of a doctor, I/we consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by the Church, I/we agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I/We also acknowledge that we 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. Further, I/we affirm that the health insurance information provided above is accurate at this date and will, to the best of my/our knowledge, still be in force for the student named above. I/We also agree to bring my/our child home at my/our own expense should they become ill or if deemed necessary by the student ministries staff member.


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