New

Life Bible Church

Consent Form



I hereby give my approval and consent to this application, and therefore
release any New Life Bible Church (NLBC) staff member, volunteer,
and/or designated adult with whom myself/my child will be lodging
from any and all liability for sickness, accidents, or injuries of any nature
caused whatsoever, while attending and traveling to or from this NLBC
event. My consent also gives permission to ride in any vehicle
designated by the adult whose care my child has been entrusted while
attending and participating in this NLBC event. I further give
authorization for any approved event leader or volunteer to transport
myself/my child to a local doctor’s office or hospital emergency room
and to secure the services of a licensed physician. I further promise to
utilize family insurance for any major medical care requiring
hospitalization and agree that I shall be liable and pay for all costs and
expenses incurred in connection with such medical services rendered to
my child pursuant to this authorization. I also give consent to the use of
any audio or visual record of the participant to be used, distributed, or
displayed for event celebration and future promotion. This consent
includes, but is not limited to photographs, video, and audio recordings.




Parent/Guardian Name (print) _______________________________________________

Signature ________________________________________ Date _________________________

Participant Name (print) ______________________________________________________

Signature ________________________________________ Date _________________________