MEDICAL RELEASE AND CONSENT FORM
My child, in consideration for being accepted and allowed to participate in the ministries of West End Presbyterian Church, Richmond, VA (9008 Quioccasin Road, Richmond, VA 23229, 804-741-6562) and activities (collectively, the “Activities”) associated with its program and location, has my permission to attend and participate in the Activities. I understand the Activities may include, but are not limited to, sports, games, trips for parks, and neighborhood parties. I represent that my child is healthy and capable of participation in the Activities without causing risk of danger, illness or accident to him or herself, or to others. Further, I, the undersigned, do hereby release, hold harmless, and forever discharge all staff members, sponsors, volunteers and counselors of West End Presbyterian Church, Richmond, as well as the Church itself and its trustees, staff, elders and deacons, from any and all claims, demands, actions or causes of action, past, present, and future, arising out of any damage or injury to my child or my property while participating in any of the Activities.
I also give my permission and consent for the staff members, sponsors, volunteers and counselors in charge of the Activities to obtain any necessary medical attention for my child in case of sickness, injury, or emergency. I release and discharge all staff members, sponsors, volunteers and counselors of West End Presbyterian Church, as well as the Church itself and its trustees, staff, elders and deacons for any liability for any first aid rendered or treatment pursuant to this consent.