By checking the box above, as the parent or legal guardian of the person listed in the box below and is under 18 years old, I hereby give permission for my child to participate in the Clinton A.M.E. Zion Church VBS Program. I understand that Clinton A.M.E. Zion Church is a nonprofit charitable institution, which is voluntarily presenting this program for my child, other participants, and the community. I also understand that the program has activities that can involve physical contact with other participants, the ground or equipment, and that there is a resulting risk of physical injury to my child.
I have explained these risks and benefits of participating in this program to my child and my child is in proper physical condition and has no existing injuries or conditions that could jeopardize his/her safety or health, or the safety or health of the other participants.
I therefore release and discharge all liability for any harm or injury suffered directly or indirectly as a result of my child's participation in the Clinton A.M.E. Zion Church VBS Program, whether or not resulting from negligence, and I agree not to sue Clinton A.M.E. Zion Church, its representatives, staff, or volunteers on any such claim. I also give permission for the staff, representative, or Clinton A.M.E. Zion Church to administer first aid or to seek medical care for my child during my child's participation in the program, including transportation of my child to a medical facility for additional treatment that appears necessary. Furthermore, I hereby grant full permission to use my name and likeliness, as well as any photographs and any record of this event in which I may appear for any legitimate purpose, including advertising and promotion.