Parent/Guardian Contact Information
CHILD PICK UP AUTHORIZATION
I, the parent(s) or guardian(s) of the above mentioned child(ren), hereby authorize Gashland Evangelical Presbyterian Church to publish photographs and videos taken of the undersigned minor child(ren), and names, for use in the Gashland Evangelical Presbyterian Church's printed publications, website, and other marketing, outreach, and communication platforms.
I release Gashland Evangelical Presbyterian Church from any expectation of confidentiality for the undersigned minor child(ren) and attest that I am the parent or legal guardian of the child(ren) listed above and that I have the authority to authorize GEPC to use their photographs, videos, and names. I acknowledge that since participation in printed publications, website, and other marketing, outreach, and communication platforms produced by GEPC is voluntary, neither the minor child(ren) nor I will receive financial compensation. I further agree that participation in any printed publications, website, and other marketing, outreach, and communication platforms produced by GEPC confers no rights of ownership whatsoever.
I release Gashland Evangelical Presbyterian Church, its contractors, and its employees from liability for any claims by me or any third party in connection with my participation or the participation of the undersigned minor child(ren).
*By entering my name in the box above, I am providing my digital signature on this form.
In the event of an emergency, this consent form gives permission to seek whatever medical attention is deemed necessary, and releases the Church and its staff of any liability against personal losses of named student.I/We the undersigned have legal custody of the child/minor named above, and have given our consent for him/her to attend event being organized by Gashland Evangelical Presbyterian Church. I/ We understand that there are inherent risks involved in any ministry or athletic event, and I/we hereby relate the church, its pastors, employees, agents, interns, 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 transportation or involvement. In the event that he/she is injured and requires 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 form a physician and or/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 the medical care not be reimbursed by the health insurance provider.
*By entering my name in the box above, I am providing my digital signature on this form.
