Signature and Release
I (Parent/Guardian) do hereby give my permission for my child to receive emergency medical care. In addition, I will not hold Duplain Church of Christ of St. Johns, MI, or any employee or representative thereof, responsible for any expense, claims, or liability arising from an injury to my child. Furthermore, I authorize the use of any media containing my child for the sole purpose of church promotion with the understanding that my child's personal information including name will not be used. I also agree to sign this form by way of electronic submission below.