Waiver of Liability

PLEASE READ AND ACKNOWLEDGE:

  • I (we) hereby authorize First Baptist Church Hopkinsville to take my (our) child/student to the named physicians or facility for medical treatment in the event of an emergency in which neither parent can be reached.
  • I (we) hereby give permission for my (our) child/student to attend and participate in activities sponsored by First Baptist Church Hopkinsville and its ministry events. I (we) hereby authorize First Baptist Church Hopkinsville to transport my (our) child/student to or from church and/or any other church related and sponsored activities and events.
  • I (we) hereby authorize First Baptist Church Hopkinsville to include child/student in supervised water activities. I (we) hereby authorize First Baptist Church Hopkinsville its acting leaders to teach and lead child/student in religious lessons and services, which include prayer and Bible teaching.
  • I (we) hereby allow an authorized adult, in whose care the minor has been entrusted, to consent to any x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment, and hospital care to be rendered to the minor under the general or special supervision and on the advise of any physician or dentist licensed under the provisions of the medical practice act on the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at the said hospital.
  • I (we) hereby do authorize any leader of First Baptist Church Hopkinsville to dispense to my (our) child/student any necessary over-the-counter medications (according to the proper dosage instructions) when deemed necessary. I (we) do hereby authorize any licensed physician or medical treatment center to treat my (our) child/student in the case of emergency in which the before named physician cannot respond. The undersigned adult shall be liable and agree(s) to pay all costs and expenses incurred in connection with such medical and dental services rendered to the afore mentioned child/student pursuant to this authorization. Should it be necessary for my (our) child/student to return home due to medical reasons or otherwise, the undersigned shall assume all transportation costs.
  • I (we) hereby release, forever discharge and agree to hold harmless First Baptist Church Hopkinsville and the directors thereof from any and all liability, claims or demands for personal injury, sickness or death, as well as property damages and expenses, of any nature whatsoever which may be incurred by the undersigned adult and the child/student that occur while participating in any trip or activity with First Baptist Church Hopkinsville.
  • I (we) [and on the behalf of my (our) child/student if under the age of 18] hereby assume all risk of personal injury, sickness, death, damage, and expenses as a result of participation in recreation and work activities involved therein. Further authorization and permission is hereby given to said church to furnish any necessary transportation, food, lodging for this participant. The undersigned further hereby agrees to hold harmless and indemnify such church, its directors, employees, and agents for any liability sustained by said church as the result of the negligent, willful or intentional acts of said participant, including expenses incurred attendant thereto.
  • The medical consent and liability waiver provision hereof shall remain in full force for one year from the date signed on the front of this form and in effect until written notice of revocation or withdrawal is received by First Baptist Church Hopkinsville at its office on 1400 South Main Street, Hopkinsville, Kentucky.
  • It is the responsibility of the parent or guardian to notify the church of any changes in medical condition, guardianship, address or phone change in writing to the address listed at the beginning of the form.
  • I hereby consent to the use, publication and display by First Baptist Church and other social media, of any pictures or video that my student may be identified. I waive all rights to inspect and /or approve any of the printed matter that may be used in conjunction with the photos and the use to which It/they may be used. I agree to hold free from any and all liability FBC and it’s staff, volunteers and teachers and myself, my heirs waive release all claims for all injuries and damages occurred.