We (I) the parent(s) or legal guardian(s) of this student hereby grant our (my) permission for him/her to participate fully in the events and activities sponsored by or attended by First United Methodist Church of Hershey during the time period of August 31, 2023 through August 31, 2024. Authorization and permission is hereby given to said church (FUMC Hershey) to furnish any necessary transportation, food, lodging, for this participant during the excursions and activities of the children's ministry program.
I understand all safety precautions will be taken at all times by First United Methodist Church and its agents during all events and activities. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold First United Methodist Church, its leaders, employees, and/or volunteer staff liable for damages, losses, disease, or injuries incurred by the participant who is the subject of this form. Furthermore, I, on behalf of my child, hereby assume all risk of personal injury, sickness, death, damage, and expense as a result of participation in recreation and work activities involved therein.
I understand that in the event medical or dental intervention is needed, every attempt will be made to contact immediately the persons listed on this form. In the event I cannot be reached or the alternate contact person cannot be reached in an emergency, I hereby give my permission to a licensed Physician or Dentist at an office or hospital selected by the activity leader to hospitalize, to secure medical treatment and/or to order an examination, injection, x-ray, anesthesia, or surgery for my child as deemed necessary.
I understand that First United Methodist Church does not carry accident or medical insurance on participating volunteers. I agree that my insurance company will be used for such medical care expenses. I am aware that I may be billed by the medical provider for any medical treatment expenses not covered by my insurance coverage and that I am responsible for the payment of any medical bills.