The safety of your student is our primary concern; precaution will be taken for their well-being and protection.
I/we, the parents or guardians named above, authorize the Pastors of West Zion Mennonite Church or one of the West Zion Mennonite Church Ministry Volunteers to sign consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above. I/we, named above, undertake and agree to indemnify and hold blameless the Pastors of West Zion Mennonite Church, the Ministry Volunteers, West Zion Mennonite Church, its Pastors and Board of Elders from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of the West Zion Mennonite Church, as well as of any medical treatment authorized by the supervising individuals representing the church. This consent and authorization is effective only when participating in or traveling to events of the West Zion Mennonite Church.
Please indicate using the boxes to grant your permission for reasonable use of photos containing your child in any or all of the following ways:*
I agree that my signature will be valid for this Consent Form for the years 2019 through and including 2025 or until my student turns 18 years of age:*
Please mark today's date:*