Youth Medical Release

Signature of Parent or Guardian

(Please  Read  Carefully  &  Fill  Out  Completely)              

I   hereby   give   my   permission   for   my   son/daughter   to   participate   in youth activities organized and/or led by the youth ministry of Calvary Chapel Sonora.  As   the   legal   parent/guardian of   the   above,   I   assume   all and full   responsibility   and   liability   for   any   illnesses,   disease,   infirmity   or   alteration   in   physical condition   sustained   by   any   person   for   any   reason   whatsoever.      I   hereby   release   Calvary   Chapel   Sonora,   its   employees and   its   officers   (including   those   ‘drivers’   helping   in   the   transportation   of   students   in   an   activity)   from   any   and   all responsibility   and   liability   in   case   of   illness,   accident,   injury,   or   death,   and   authorize   any   medical   care   deemed   necessary by   an   accredited   physician,   nurse,   paramedic   or   hospital   while   involved   in the   aforementioned   activity.      In   the   event   of illness,   accident   or injury   while   the   student is   in   the   care   of   Calvary   Chapel   Sonora,   I understand   and   agree   that   I   am   financially   responsible   for   any   care   provided.  

In   the   event   that   it   becomes   necessary   or   advisable   for   any   reason   whatsoever   to   alter   the   itinerary   or   arrangements, the   leadership   reserves   the   right   to   make   such   alterations.    

I   understand   that   I   will   be   required   to   pick-up   that   aforementioned student   at   the   leadership’s   request   if   the   participant’s behavior   is   contrary   to   the   spirit   and   intent   of   this   activity.                

The   signing   of   this   form   by   the   parent   or   legal   guardian   shall   be  consent   to   the   above   conditions.

Physician's Name

We   do   not   anticipate   any   problems,   however,   your   student   may   be   treated   by   a   physician   without   parental authorization.      Naturally,   you   will   be   called   immediately   if   we   do   have   any   problems,   but   there   is   always   the   possibility   that promptness   in   treatment   may   be necessary.      This   is   not   said   to   alarm   you,   but   to   make   you   aware   that   your   child   will   be protected   in   every way   possible.              
Please   list   below   any   pertinent   information   that   might   concern   your child’s   health,   such   as   allergies,   drugs,   chronic ailments   or  disorders, etc.
Social Media Permission

On   occasion   we   like   to   post   pictures   of   our   events   on   Social   Media.     Our   intention   is   to   keep   families   and   the   church involved   in   our   fellowship.