RELEASE OF ALL CLAIMS: In
consideration of being accepted for participation in Vacation Bible School, I
(we) do for myself (ourselves) and on behalf of my child/participant do hereby
release, forever discharge, and agree to forever hold harmless Augustus
Lutheran Church and the Southeastern Pennsylvania Synod, ELCA, the employees,
and agents thereof, from any and all liability, claims and demands for personal
injury, sickness and death, as well as property damage and expenses of any
nature whatsoever which may be incurred by me or my child/participant resulting
from said child’s participation in the synod sponsored youth events, including
travel, recreation and all associated activities. Further, I (we) (and on
behalf of our child/participant under 18 years of age) hereby assume all risk
of said personal injury, sickness, death, damage and expenses as a result of
participation as above set forth. I also understand that staff and
volunteers are not responsible for the administration of prescribed medication and
I (we) have made private arrangements for any medication taken on a daily
schedule by my child/participant. I (we) am (are) the parent(s) or legal
guardian(s) of this participant, and herby grant my (our) permission for
him/her to participate fully in said youth events, and give my (our) permission
to take said participant to a doctor or hospital, share the above medical
information and authorize medical treatment, including, but not limited to
emergency surgery or medical treatment, and assume responsibility of all
medical bills incurred by my child. I (we) give permission for the participant
to receive over the counter medication such as Tylenol, ibuprofen,
anti-diarrheal medication, antibacterial ointment, throat lozenges, eye wash
solution, and the like. I (we) also release the participant’s name as part of
an information database for the church, synod and ELCA related entities. I (we)
also grant Augustus, the synod and ELCA unrestricted rights to use, alter, and
reproduce any images (still and video) from the event, in any medium without
compensation.*
