| My
child has
my permission to attend AWANA activities sponsored by Grace Evangelical Free Church. I will not hold Grace Church, nor any of its AWANA leaders, responsible for any injuries the above named clubber may incur while participating in club activities on Tuesday nights, while traveling to or from or participation in any AWANA sponsored events.
As a parent (or guardian), I do hereby authorize the treatment by a qualified & licensed medical doctor, of the above named minor, in case of a medical emergency that may, in the opinion of the attending physician, endanger his/her life, cause disfigurement, physical impairment, or undue discomfort if delayed. This authority is granted only after every reasonable effort has been made to reach me.
This release form is completed and signed of my own free will, with the sole purpose of authorizing medical treatment, under emergency circumstances, in my absence.
The effective date of this release is from August 23, 2011 through May 22, 2012.
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