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Minor Consent Form

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Registration & Emergency Information Form 201118
  • - ONLY COMPLETE THIS FORM ON CHROME AND FIREFOX BROWSERS

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  • By signing Item 31, I am stating that I have ready the two PDFs below, the Emergency Medical Treatment and Release of Liability statement below, I am aware of First Cutlerville CRC's guidelines for Covid-19, and will follow the directions listed.

    FCVCRC Kids Health & Safety Plan Classrooms PDF

    FCVCRC Code of Conduct Policy PDF

  • 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.

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