CONSENT AND CERTIFICATION:
By signing below, I, being the parent or legal guardian of the child(ren) named below, do hereby consent to the participation of my child(ren) and/or youth in any The Well International activities. I certify that my child(ren) are physically fit and adequately prepared to participate in any event.
MEDICAL TREATMENT AUTHORIZATION:
I understand that I will be notified in the case of a medical emergency. However, in the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event that my child(ren) is injured or becomes ill. I authorize one or more of the following persons listed below to make emergency medical care decisions on behalf of my child(ren), if required by law or health care provider, or another adult chaperone designated by the pastor. I authorize these persons to act in my place to consent to all necessary and appropriate medical diagnosis and treatment, or hospital care.
TRANSPORTATION & TRAVEL AUTHORIZATION:
By checking the box below, I give consent for my child(ren) and/or youth to be transported by vehicles to activities if need be. I understand that The Well Internations (it's affiliates, volunteers, chaperones or anyone associated with The Well International) will not be held responsible for any medical expenses or from any legal liability in the case of any injury or illness during transportation to and from any event. This includes overnight stay and/or out of state travel.
I understand that The Well International (it's affiliates, volunteers, chaperones or anyone associated with The Well International) will not be responsible for the medical expenses incurred solely on the basis of this authorization and release The Well International (it's affiliates, volunteers, chaperones, or anyone associated with The Well International) from any legal liability in the case of any injury or illness. I also understand that the designated adult chaperones reserve the right to restrict my child from any activity that they do not feel is within the physical capabilities of my child.