As the parent or guardian, I do herewith authorize the treatment by a qualified and licensed medical doctor of the following minor in the event of a medical emergency which in the opinion of the attending physician may endanger the life, cause disfigurement, physical impairment or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me. I also release Shandon Baptist Church, other organizations and individuals involved, of any liability for any accident incurred during the Wednesday night activities.
This release is intended to be used during the entire year, September 2017-May 2018. This release form is completed and signed of my own will and with the sole purpose of authorizing medical treatment under emergency in my absence.