In the event I cannot be reached in an emergency, I hereby give my permission to the physician or dentist selected by the church leadership to hospitalize, to secure proper treatment, and/or order an injection, anesthesia, or surgery for my son or daughter as deemed necessary.
Every activity sponsored by Grace Chapel Church is carefully planned and adequately supervised by mature adults. Even with the best planning and precautions, unforeseen events or accident can occur. By providing my electronic signature on this form, the below indicated parent, guardian, or legal representative of the child or children named herein signifies that he or she fully understands the church activity participated in and accepts all risks and hazards inherent in such church activity.
Further, the below indicated parent, guardian, or legal representative of the child or children named herein agrees to hold harmless Grace Chapel, its employees, or volunteer assistants from any and all liability for damages, losses, or injuries to the person or property of any child or children named herein caused by acts or omissions amounting to simple negligence and to refrain from instituting any cause of action against any volunteer or person employed by Grace Chapel of Grace Chapel to recover losses, whether medical or otherwise arising from acts or omissions amounting to simple negligence in any court in the State of Oregon.