This consent form gives permission to seek whatever medical attention is deemed necessary, and releases Tullahoma First Assembly of God and its staff of any liability against personal losses.
I, the undersigned, willingly allow my son/daughter to participate in
WINTERJAM,
organized by Tullahoma First Assembly of God. In the event that he/she is injured and requires the attention of a doctor, I consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by the church, I agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I also acknowledge that I will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance provider. Further, I affirm that the health insurance information provided above is accurate and active for any care my child may require.
I give my permission for Tullahoma First Assembly of God to use my child’s picture on their website, app, social media sites, and for media releases (web & print) in which to advertise a church event.
