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Minor Consent Form

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Minor Consent Form
  • - ONLY COMPLETE THIS FORM ON CHROME AND FIREFOX BROWSERS

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  • By signing Item 32, I am stating that I have read the Code of Conduct PDF below and the Emergency Medical Treatment and Release of Liability statement below.

    FCVCRC Code of Conduct Policy PDF

  • Emergency Medical Treatment and Release of Liability Statement 

    I recognize that there may be occasions where the participant may be in need of first aid or emergency medical treatment as a result of an accident, illness, or other health condition or injury. I give permission for all agents (paid staff or volunteers of First Cutlerville Christian Reformed Church to seek and secure any medical attention or treatment for the participant, including hospitalization. If in the agent’s opinion, such a need arises, I give permission for attending physician(s) and other medical personnel to administer any needed medical treatment. I agree to pay all fees and costs involved. I understand I will be notified as quickly as possible. I agree to hold harmless and blameless First Cutlerville Christian Reformed Church and its' agents, and waive all rights to civil action that participant may have or that I may have against them as a result of injury or illness incurred during the course of participation in church activities.

  • Electronic Signature Acknowledgment

    I agree and understand that by signing the Electronic Signature Acknowledgment for this Minor Consent Form, that:
    -all electronic signatures are the legal equivalent of my manual/handwritten signature
    -that I have read, understand, and agree to the information above
    -if this information changes in the future, I will complete a new form
    -and I consent to my child's participation in the ministries of First Cutlerville CRC

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