Consent and Certification
I, the undersigned, being the parent or legal guardian of the child named above, do hereby consent to the participation of my child in all the scheduled activities of The Korean Central United Methodist Church of Dallas(KCUMC), and any other supervised activities customarily associated with its group, including but not limited to home visitations, camps, retreats and field trips.
Further, I certify that my child is physically fit and adequately prepared to participate in all recreational and sporting events. I understand that KCUMC and its members are free of any responsibility in case of accidents or medical emergencies. If I wish to revoke this consent for any reason, I will promptly notify the leader in writing.

I understand that The Korean Central United Methodist Church of Dallas will not be responsible for medical expenses incurred solely on the basis of this authorization. I further agree to notify the pastor in writing of any health changes that would restrict my child’s participation in any normal youth activities. I also understand that the leaders and designated adult chaperones reserve the right to restrict my child from any activity that they do not feel is within the physical capabilities of my child.

Medical Treatment Authorization
I understand that I will be notified in the case of a medical emergency. However, in the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event that my child is injured or becomes ill.
I authorize one or more of the following persons to make emergency medical care decisions on behalf of my child, if required by law or a health care provider; ministry pastor and another adult chaperone designated by the pastor. I authorize these persons to act in my place to consent to all necessary and appropriate x-ray examinations, anesthetic, medical or surgical diagnosis or treatment, and hospital care.