I hereby give my permission for my above listed child/children to participate in the AWANA program at Emmanuel Baptist Church and all AWANA related events and outings for the school year listed above.  I assure that he/she/they/is/are in good health and able to participate. 

I do herewith authorize emergency treatment under the direction of any licensed physician of the above named minor in the event of a medical emergency which, in the opinion of the attending physician, may endanger life, cause disfigurement, physical impairment or undue discomfort.  This authority is granted only after a reasonable effort has been made to contact me or those listed at the phone number(s) listed below.  I also assume responsibility for any and all just fees and costs connected with this treatment and hereby release the Emmanuel Baptist Church and AWANA Club from any liability therefore.

If there is a behavior problem with  my child(ren), I welcome a call, and if requested, will arrange for their immediate transportation from the activity.

I hereby release and absolve, Emmanuel Baptist Church, of any and all liability arising from my child’s/children’s participation in, including Game Times, and with the ministry listed above.

I authorize pictures of my child to be used for AWANA crafts and potentially posted on the Emmanuel Baptist Church Facebook Page. 

This release form is completed and signed of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence.

Please provide Digital Signature below.