Children and Student Medical/Liability/Marketing Release Form

Please fill out our Release Form to allow your child to participate in all SPBC-sponsored activities.
GENERAL & EMERGENCY CONTACT

 
 
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INSURANCE

 
 
 
 
 
HEALTH

 
 
 
 
 
 
 
 
 
 
 
 
Please select all that apply.
RELEASES

LIABILITY RELEASE: I, the parent / legal guardian, through the submission of this form, do hereby release, acquit, hold harmless, and forever discharge South Point Baptist Church (henceforth referred to as SPBC), its agents, servants, and employees, and all persons, natural or corporate, in privities with them or any of them, from any and all claims or causes of action of any kind whatsoever, including but not limited to actions, suits, and/or claims for any bodily injuries, death, or property damage which may be sustained by the child listed above while participating in any Children/Student Ministry activity, or activities, (including travel to and from such activities) resulting from the negligence or lack of care due or claimed to be due to the conduct of any agent, servant, or employee of the SPBC, for any and all activities.

MEDICAL RELEASE: I, the parent/legal guardian, through the submission of this form, give and grant unto any licensed medical doctor or hospital my consent and authorization to x-ray or rend such aid, treatment, or care to said child as in the judgment of doctor or hospital, may be required, on an emergency basis, in the event said child should be injured or stricken ill while participating in an SPBC sponsored event. It is further understood that any expense incurred will be paid for by the insurance or the parent/legal guardian. I also understand that if the child needs to be sent home for any reason (i.e. illness, injury, or disciplinary), I will be contacted at one of the numbers above, and I will be responsibile for any and all expenses incurred.
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MARKETING RELEASE: I, the parent/legal guardian, through the submission of this form, grant SPBC permission to use my child's name, photos, audio recordings, and DVD's made at any SPBC event for the purpose of publicity, promotional materials, and website content.
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Description

Please fill out our Release Form to allow your child to participate in all SPBC-sponsored activities.