I/We the undersigned have legal custody of the student named above, a minor, and have given our consent for him/her to attend RECHARGE Winter Retreat, organized by Crossroads Community Church. I/We understand that there are inherent risks involved in any ministry or athletic event, and I/we hereby release Crossroads Community Church and Silver Birch Ranch, its employees, agents, and volunteer workers from any and all liability for any injury, loss, or damage to person or property that may occur during the course of my/our childs involvement. In the event that he/she is injured and requires the attention of a doctor, I/we consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by Crossroads Community Church and/or Silver Birch Ranch, I/we agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I/We also acknowledge that we will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance provider. Further, I/we affirm that the health insurance information provided above is accurate at this date and will, to the best of my/our knowledge, still be in force for the student named above. I/we also agree to bring my/our child home at my/our own expense should they become ill or if deemed necessary by the student ministries staff member.
I hereby grant permission to Crossroads Community Church to use my child(ren)'s photo on their website(s) or in any other official publications, promotional materials and videos, and I acknowledge Crossroads Community Church's right to crop or treat the photo at their discretion. I also understand that once the image is posted on a website, Facebook or newsletter, the image can be downloaded. Therefore, I agree that Crossroads Community Church is not held responsible for such occurrences.