In case of an emergency during AWANA:
I hereby authorize the emergency medical treatment of my child while under the care and custody of Lake Hills Baptist Church and hold harmless the church and its agents or assigns and representatives, including volunteer workers for any harm deemed to arise from the aid of said treatment or the lack of said treatment.
I understand that Lake Hills Baptist Church nor its workers are responsible for administering any medications required to be taken by my child and this is the sole responsibility of my child; and I acknowledge that LHBC nor any of its workers are authorized to make any medical diagnosis nor administer any medical procedures, except those actions deemed proper and necessary in an emergency where they may act as a "Good Samaritan" and render aid and assistance as allowed under the laws of Indiana, whose jurisdiction is agreed to by myself as applicable.
A copy of this document shall be valid as though it were original.
*By entering my name in the box above, I am providing my digital signature on this Form.
Activity: Awana
Location: Lake Hills Baptist Church
Activity may include: Variety of games including but not limited to running, throwing, jumping.
Date of Activity: Sept 2020-April 2021
Time of Activity: Wednesdays, 6:15-8pm
By signing below, the parent/guardian gives consent to the said child to participate in a church sponsored activity. The undersigned agrees to hold harmless (which means to not assign blame or legal responsibility) the Lake Hills Baptist Church, its officials and those workers assisting in the activity from any and all harm that may be sustained as a result of or during the activity, including transportation to and from the activity. Parent further agrees to resolve any dispute arising from any harm where the matter is, by mutual consent, deemed not covered by this consent or over the consent itself, by submission to binding arbitration.
*By entering my name in the box above, I am providing my digital signature on this Form.
