Fulton Church Varsity Club Consent Form

2017/2018 | Please fill out this form if your child will be participating in any Varsity Club activities for the 2017/2018 year.

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Health

Emergency Contact

Media Release

I understand that my Child may be photographed at different Varsity Club events. I hereby assign all rights to the photographs/video made of my Child by Fulton Church. I hereby authorize and consent to the editing, reproduction, exhibition and use of said photographs/video by Fulton Church for promotional purposes in its publications, on its Web site and in local print media. I acknowledge Fulton Church’s right to crop or treat the photographs/video at its discretion.
Consent Release

I hereby give permission for my Child to attend and participate in Fulton Church Varsity Club events. Prior to my Child’s involvement in the Event activities, I acknowledge that involvement of my Child in the Event may involve risk of property damage and of personal injury, illness or even death, including but not limited to the risks arising from transportation–related activities, recreational activities, accidents in and around facilities, adverse weather conditions, and injuries and illness as a result of food-borne illnesses and allergic reactions.

By signing this Parental Consent and Release of Liability, I state that my Child is fully capable of safely participating in all Event activities, and I expressly assume all risks of my Child’s involvement, whether such risks are known or unknown to me at this time. I further generally release Fulton Congregational Church its directors, officers, employees, volunteers, and agents, and other participants at the Event, from any and all claims that I or my Child may have against any of them, whether on or off Event grounds. This Release of Liability is given on behalf of myself, my Child, and any heirs, family, estate, administrators, and personal representatives of me and my Child.
I expressly agree that this Release is intended to be as broad and inclusive as permitted by the State of Wisconsin. I hereby give my consent that my Child may receive medical treatment that may be deemed advisable in the event of injury, accident and/or illness during this event.
I represent and warrant that I am a parent or legal guardian of the Child named above, and have the full power and authority to enter into this Parental Consent and Release of Liability on behalf of my Child. By signing below, I acknowledge that I have read and understand this document, and also represent that all information provided is accurate.

Description

2017/2018
Please fill out this form if your child will be participating in any Varsity Club activities for the 2017/2018 year.

Click submit.