PERMISSION/INFORMATION/RELEASE FORM MOUNT OLIVET LUTHERAN CHURCH 5025 Knox Avenue South, Minneapolis, MN 55419-1095 Phone (612) 926-7651 Fax (612) 926-4340 7150 Rolling Acres Road, P.O. Box 153, Victoria, MN 55386-7705 Phone (952) 767-1500, Fax (952) 470-4589
This form gives permission for my child to participate in and/or travel with Mount Olivet Lutheran Church, its staff, volunteers, representatives, agents, for all Mount Olivet Lutheran Church events for the program year of September 1, 2017 through August 31, 2018.
Please read the following statements carefully and date and sign this form:
By selecting you have read this form online, you are releasing Mount Olivet Lutheran Church, its employees, representatives, agents, and volunteers from any liability, personal injury, death, or property loss incurred in connection with the Event(s). You are also giving Mount Olivet Lutheran Church, its employees, representatives, agents, and volunteers permission to seek whatever medical attention is deemed necessary in the event of an emergency and to provide preventative care to minor children.
I/we understand that there are inherent risks involved with any trip or activity and, therefore, I/we agree (on behalf of myself, my spouse and/or my/our minor child) that Mount Olivet Lutheran Church, together with its employees, representatives, agents, and volunteers (collectively, “the Church”) shall not be responsible for and are hereby released from any liability for any personal injury, death, or property loss incurred in connection with the Event(s) of the time period noted above. I/we also authorize the Church to seek emergency medical treatment on behalf of me and/or my/our minor child in the event that such treatment is deemed necessary or appropriate by the Church and release the Church from any liability related to that decision or treatment. I/we further authorize the Church to provide preventative care to me and my/our minor child, including, but not limited to, the application of insect repellent and sunscreen and release the Church from any liability related to that care.
I/we understand that participation by me and/or my/our minor child in the Event(s) is voluntary. I/we further understand that any necessary transportation for the Event may be provided in vehicles driven by the Church or by third-party commercial carriers. I/we understand and agree that the scope of this release does not extend to willful, wanton, or intentional misconduct on the part of the Church.