Functions and Activities: It is my understanding that participating in the programs and recreational and other activities of Cornerstone Christian Reformed Church of Chilliwack, B.C. is a privilege. Prior to my youth’s participation in such activities, I acknowledge that there are certain risks associated with the activities including, illness—including illness from Covid-19--or even death. In addition, I acknowledge that there may be other risks inherent in these activities of which I may not be presently aware.

Release of Liability: By signing this Permission/ Waiver Form, I expressly warrant that the youth named above is capable of withstanding the physical demands of the activities discussed above. I also expressly assume all risks of the youth participating in the activities, whether such risks are known or unknown to me at this time. I further release Cornerstone Christian Reformed Church of Chilliwack, B.C. and its ministers, leaders, employees, volunteers, or agents from any and all claims arising from my participation in its activities and programs, or as a result of injury or illness of my child during such activities.

First Aid and Emergency Medical Treatment: I recognize that there may be occasions where the child named above may be in need of first aid or medical treatment as a result of an accident, illness, or other health condition or injury. I do hereby give permission for agents of Cornerstone Christian Reformed Church of Chilliwack, B.C. to seek and secure any medical attention or treatment for the youth named above, including hospitalization, if in the agent’s opinion such need arises. I agree to pay all fees and costs arising from this action to obtain medical treatment. I give permission for attending physicians and other medical personnel to administer any needed medical treatment, including surgery and, again, I agree to pay for the medical treatment.

Special Events and Field Trips: I understand that the youth named above will be participating in various activities from September 1, 2023 through August 31, 2024 (including summer activities that take place in July & August). I understand that during this period my youth may take part in activities consistent with the purposes of the church. I also understand that I may be asked to sign Special Permission/ Release Forms in addition to this form.

Publicity: On occasion, Cornerstone Christian Reformed Church of Chilliwack, B.C. takes photographs or makes an audio or video tape recording of the youth and/ or adults involved in church activities. Such photographs or video records may be used by staff and participants to remember the activities or participants. In addition, such photographs and audio/ visual recordings may be used in Cornerstone Christian Reformed Church of Chilliwack, B.C. publications or advertising materials to let others know about our ministry. In addition, local news organizations may hear of our activities and events, and our church may invite or allow them to photograph or record our events for news reporting on special interest features. I consent to the use of any such audio or visual record of the youth named above to be used, distributed, or displayed as agents of the church see fit. This consent includes but is not limited to: photographs, videotapes, and audio recordings. Furthermore, I give permission for the youth to be interviewed by the news media, or for such photographs and other audio or visual records to be used by the news media.

Parent/ Guardian Authorization: I represent that I am the parent/ guardian of the above youth, who is under 19 years of age. I have read the above Permission/ Waiver Form and am fully familiar with the contents thereof.

I give permission for the youth named above to participate in the activities of Cornerstone Christian Reformed Church of Chilliwack, B.C., including any special events/ activities described above. In consideration for allowing the participation of the youth in the activities of Cornerstone Christian Reformed Church of Chilliwack, B.C., I hereby consent to the Permission/ Waiver Form, including the Release of Liability above, on behalf of the youth, and agree that this Permission/ Waiver Form shall be binding upon me, my family, heirs, legal representatives, successors, and assigns.

I also understand that it is my responsibility to see that the information on this form is updated when there are any changes in my youth’s medical status, etc.