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Minor Consent Form Inactive 201118

Registration & Emergency Information Form
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  • By signing Item 27, I am stating that I have read the two PDFs below, the Emergency Medical Treatment and Release of Liability statement below, I am aware of First Cutlerville CRC's guidelines for Covid19, and will follow the directions listed. 

    FCVCRC Kids Health & Safety Plan Classrooms PDF

    FCVCRC Code of Conduct Policy PDF

  • Emergency Medical Treatment and Release of Liability:

    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 Fist Cutlerville Christian Reformed Church and her 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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