Medical Release: By signing my name in the box below, I agree that I am the parent or guardian of the participant listed above, or am the participant myself, and am over the age of 18, and agree to the following conditions: I give my consent to BattleCreek Church, including any medical personnel, staff or volunteers participating in TUL Weekend, to administer to the participant any medical treatment, including medication, they deem necessary during the participant's participation at TUL Weekend. I further authorize BattleCreek Church staff and volunteers to obtain for the participant any outside or off-site medical and/or surgical treatment they deem necessary and authorize the treating physician (chosen by BattleCreek Church) and his or her medical staff to carry out any medical and/or surgical treatment in accordance with the treating physician's diagnosis. I understand that I will be notified, as soon as practicable, of any medical treatment administered to the participant and will be responsible for all costs associated with any such medical treatment. I also give BattleCreek staff and volunteers permission to transport the participant to obtain medical treatment or in the event of an emergency. I hereby agree to hold BattleCreek Church, including its representatives, agents, employees and volunteers, free of any and all liability, actions, causes of actions, claims, expenses and damages on account of injury to the participant or property; even injury resulting in death, which may arise in connection with the participant's participation in TUL Weekend or any other associated activities, including the administration of medical treatment.
Medical Release First & Last Name Signature
Central Office | 3025 N Aspen Ave, Broken Arrow, OK 74012 | Phone: