The undersigned represents to West Side Presbyterian Church (herein referred to as WSPC), a non-profit religious corporation, that he or she is the natural parent or the legal guardian of the above named child; and, the undersigned does hereby consent to such child taking part in the WSPC West Side Wednesdays with the full understanding insofar as such activity will involve missions and sporting activity and mingling with other individuals and groups, that there is always risk of injury, illness, loss, and possible consequent expense for medical, diagnostic, and curative treatments, and incidental loss and expense, and the undersigned does for him/herself and for and on behalf of such child assume the risk of such and expense, and does hereby wholly release WSPC from any responsibility of liability and waives any claims or causes that might arise on account of loss, injury, or expense occasioned by any sort of accident or other circumstance involving such child, and agrees to hold harmless WSPC in the event any such claim should arise, and
Waiver of Liability
I authorize the administration of all medical, dental, and surgical examinations, operations, treatment, and all related care, including emergency or ambulance transportation and the administration of drugs, test, anesthesia and blood transfusions to the above-named minor when physician or dentist at the treating medical facility deems those procedures necessary for emergency treatment. I consent to the release of medical report(s) to any doctor or agency and consent to the admission of the above-named minor person to the hospital. I understand that West Side Presbyterian Church, and their officers, employees, and volunteers assume no financial obligation or liability in case of my child’s accident or illness. I assume financial responsibility for emergency treatment for my child.