Emergency Contact (other than Parents)
Medical Release Statement
I understand that, in the event of a medical emergency while my children are under the care of Living Vine Community Church and its representatives and I am not available, Living Vine Community Church will call for emergency medical treatment. I hereby consent to and will be responsible for any reasonable medical treatment as deemed necessary by a licensed physician. I understand that every possible attempt will be made to contact me in the event of an emergency. I agree to hold the physician, medical facility, Living Vine Community Church and its representatives free and harmless of any claims, demands or suits for damages arising from the authorization and provision of such medical treatment.
Living Vine Community Church is collecting and retaining this personal information for the purpose of enrolling your child in our programs, to assign the student to the appropriate classes, to develop and nurture ongoing relationships with you and your child, and to inform you of program updates and upcoming opportunities at our church. This information will be maintained permanently as it is a requirement of our insurance company and legal counsel. If you wish Living Vine Community Churchto limit the information collected, or to view your childs information, please contact us.
I agree that pictures or videos of activities that may include my child might appear on the church website, social media pages, or in other forms of communication and publication from the church. (If at any time you wish to remove this authority, please contact the church office.)
By typing my name below, I am stating I have read and agree to all the information above, and that I am the legal parent or guardian of the children named in this form.