Recognizing that my participation with Wiley Student Ministries is a revocable privilege, I, the undersigned Student, have read the Student Expectations and Student Prohibitions, and agree to abide by them while participating and attending Wiley Student Ministry or Wiley Union Church sponsored activities, excursions, or events.
Furthermore, I will participate with Wiley Student Ministries in full consideration of my personal health status, physical abilities, and limitations and will hold harmless Wiley Student Ministries, Wiley Union Church, their staff and volunteers of any liability or loss related to my participation in activities, excursions, or events sponsored by Wiley Student Ministries or Wiley Union Church.
This consent form gives Wiley Student Ministries, Wiley Union Church, its staff and/or volunteers (hereafter, "the Church") permission to seek whatever medical attention is deemed necessary, and releases the same of any liability against personal losses of named child.
I/We the undersigned have legal custody of the student named above, a minor, and have given our consent for him/her to attend events being organized by the Church. I/We understand that there are inherent risks involved in any ministry or athletic event, and I/we hereby release the Church, its pastors, employees, agents, and volunteer workers from any and all liability for any injury, loss, or damage to person or property that may occur during the course of my/our child’s involvement. In the event that he/she is injured and requires the attention of a doctor, I/we consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by the Church, I/we agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I/We also acknowledge that we will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance provider. Further, I/we affirm that the health insurance information provided above is accurate at this date and will, to the best of my/our knowledge, still be in force for the student named above. I/we also agree to bring my/our child home at my/our own expense should they become ill or if deemed necessary by the student ministries staff member. I/We also agree to support and enforce the Student Expectations and Student Prohibitions identified in this form while our student participates with the Church.