General Permission (please read and type your name as a signature and acknowledgement at the bottom): I give the participant listed on this form permission to participate in Centerville Baptist Church ministry events and outings. I realize that this is a general form to be placed on file in the church ministry office for church use when deemed necessary. As the parent/guardian of the participant, I certify that the information provided on this form is correct to the best of my knowledge. In order for appropriate diagnosis and prompt treatment in the event of a medical emergency, I give permission for such diagnostic, therapeutic, and operative procedures as may be deemed medically necessary for treatment of the herein named participant. I assume financial responsibility for medical expenses incurred in the transport and treatment of the participant. I also assume financial resonsibility for expenses incurred in returning the participant home for any of the folllowing reasons: substance abuse, endangering the life of another person, sexual misconduct, illegal activity or other continual disruptive behavior. I understand that each individual is responsible for his/her own insurance coverage during any trip. I hereby release and forever discharge Centerville Baptist Church, its staff, all sponsors, state conventions, employees, and any designated individual in charge of any trip from any legal responsibility, financial responsibility, claims, demands, actions or cause of action, past, present, or future, arising from my personal or my child's participation in any church activity. Please type your name below as acknowledgement. *
