Minor - Woodland Baptist Church 2022 Medical, Surgical, Liability, & Photo/Video Waiver

The Minor - Woodland Baptist Church 2022 Medical & Surgical Waiver will apply to all church events and projects from January 1, 2022  through December 31, 2022. It will give Woodland Baptist Church an adequate, current, usable record of each person's medical information and will give hospitals information, including parental permission, in case your child needs medical attention.

Please fill out the information thoroughly. It is the responsibility of the parent or guardian to keep this information current.

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WAIVERS
Please indicate your agreement with your initials.

 

I am the parent and/or legal guardian signing for a minor and hereby acknowledge that said minor is presently under my care, custody and control. I hereby give my child, the said minor, my express permission to participate in any all activities at and with Woodland Baptist Church, San Antonio, Texas, in which my child, with my approval, registers to participate. I further expressly grant my permission for my child to participate in all activities while an active participant on all trips and church events. The information below is accurate.

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In the event there arises an emergency, necessitating medical or surgical attention, I hereby consent and give my permission to the Woodland Baptist Church staff and its representatives, upon said minor, which may in their sole discretion be necessary and proper under the circumstances.

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I, the undersigned parent and/or guardian of said minor, do release, acquit, discharge and covenant to indemnify and hold harmless Woodland Baptist or its representatives, sponsors or attending physician, from any and all actions, causes of actions, related risks and dangers, including negligence, damages, liabilities arising out of the treatment of any sicknesses or accident, and financial responsibility for all medical treatment provided during the attendance of any trip or events.

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DISCIPLINE
I also assume responsibility for said minor providing any transportation from the event location should it be necessary for disciplinary reasons.

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PHOTO/VIDEO RELEASE

I hereby grant permission for Woodland Baptist Church of San Antonio to record pictures or videos of said minor while on the church property or at a church-sponsored event. I also give permission to Woodland Baptist Church of San Antonio to use these images or videos in church print and online publications (including church websites and social networks).

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Signee Information

Include name, relationship, and best phone number.

MEDICAL INFORMATION

Include name and phone number.






Please check all that apply.

Please put "none" if none.

Medication, Dose, Frequency, Purpose Please put "none" if none.

MEDICAL INSURANCE

You agree to receive emails from Woodland Baptist Church.

By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.