Parent/Gardian Name *

First Name

Last Name

Parent/Guardian Phone *

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Emergency Release Agreement *

I/we hereby authorize emergency medical, dental, health, or hospital services to be rendered to my child upon consent of Trinity Lutheran Church staff member or designated volunteer. The purpose of those authorization is to permit my child to receive emergency medical attention when needed while involved in the activities connected with Trinity Lutheran Church in Arlington, SD when I or my emergency contact is unavailable to give consent.

Liability Release Agreement

I/we understand there are inherent risks involved in any activity, including but not limited to the risk of injury from transportation or physical activity. Being fully informed of the inherent risks, I/we hereby release Trinity Lutheran Church as well as its staff and volunteer workers from any and all liability due to an injury, loss, or damage to person or property that may occur during my involvement with Children and Youth Programs at Trinity Lutheran Church.