Please enter name for someone other than a parent RPC can contact if parent cannot be reached.

Please list any adults who have permission to pick up your child.  Also, please advise of any custody situations the church should be aware of.

By initialing below, I acknowledge that photographs may be taken during VBS, and give Redeemer Presbyterian Church permission to photograph my child(ren) for event related purposes.  Photographs may be printed or published online; however, names will NOT be published with pictures.  

I/We the undersigned have legal custody of the minor child(ren) named above and hereby give our consent for him/her/them to attend events being organized by RedeemerPresbyterian Church ("Church" or "RPC").  If a child experiences a medical situation, every effort will be made to contact the legal guardians/parent(s) first.  In the event the legal guardians/parent(s) are not available and the child needs medical attention, this consent form gives permission to the Church to seek whatever medical attention is deemed necessary, and releases the Church and its staff from any liability for personal losses, damages, injuries or death of said child.  I/We understand that there are inherent risks involved in any ministry event or athletic event, and I/we hereby release the Church, its ministers, employees, agents, and volunteer workers from any and all losses or damage to persons or property that may occur during the course of my/our child’s (children's) involvement.  In the event that he/she/they suffer injuries and require the attention of a doctor or emergency medical personnel, I/we consent to any reasonable medical treatment as deemed necessary by a licensed physician or emergency medical personnel.  In the event treatment is required from a physician, emergency medical personnel and/or hospital personnel designated by the Church, I/we agree to indemnify and hold such persons free and harmless of any claims, demands, or legal actions for any and all damages arising from the giving of this consent.  I/We also acknowledge that we will be responsible for the cost of any medical/emergency care should the cost of that medical/emergency care not be reimbursed by our health insurance provider.