LIABILITY RELEASE: In consideration of Summit Church allowing the above child(ren) to participate in Vacation
Bible School activities, we (I), the undersigned, do hereby release, forever discharge and agree to hold
harmless Summit Church, its directors, employees, volunteers and agents (collectively herein the “Church”)
from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property
damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the above
child(ren) while involved in Vacation Bible School. Furthermore, we (I) [and on behalf of our (my) minor child(s)]
hereby assume all risk of accidental personal injury, sickness, death, damage, and expense as a result of
participation in activities involved therein. As well as releasing the child(ren) if necessary for transportation to
and from the Vacation Bible School location. We(I), the undersigned, do hereby release, forever discharge,
and agree to hold harmless Summit Church, directors, employees, volunteers, and agents from any and all
liability, claims or demands for accidental personal injury in the process of transportation.
MEDICAL TREATMENT PERMISSION: We (I) authorize an adult, in whose care the minor has been entrusted, to
consent to any emergency x-ray examination, anesthetic, medical, surgical, or dental diagnosis or treatment
and hospital care, to be rendered to the minor under the general or special supervision and on the advice of
any physician or dentist licensed on the medical staff of a licensed hospital or emergency care facility. The
undersigned shall be liable and agree(s) to pay all costs and expenses incurred in connection with such
medical and dental services rendered to the aforementioned child or youth pursuant to this authorization.
PHOTO/PICTURE PERMISSION: I (we) give my (our) consent to Summit Church to use photo or video images
taken of my (our) child(ren) in church brochures, advertisements for the church, on the website, in social
media, and in other church publications as they see fit. I agree to hold harmless Summit Church
from any liability which may result from the use of said picture(s). This form will apply throughout my (our)
child(ren)’s tenure at Summit Church’s Vacation Bible School.
**None of the photos to be taken will be for personal use.
