Informed Consent And Waiver Agreement
I, the parent or guardian name above, do hereby agree to, and give permission for:
A) the children named herein to participate in the Centre Street Church Children's Ministries ("the Program") and assume all risk of loss, expense, damage or injury resulting from their participation in the activites of the Program, and
B) do hereby give permission for staff members of Centre Street Church to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant(s).
I, the parent or guardian named above, in consideration of Centre Street Church registering the participant(s) in the program, undertake and agree as follows: To waive any and all claims that i have or may have in the future have against Centre Street Church, its staff members, Board of Governors, employees and volunteers, and their agents, representatives, successors and assigns (collectively referred to as the "Releasees"), and to release the Releasees of any and from any and al losses, expenses, damages, and claims arising our of or in connection with injury or damage suffered by the participant(s) as a result of participating in the activities of the Program. And to indemnify and hold harmless the releasees from any and all liability for and losses, expenses, damages and claims arising our of or in connection with injuries or damage to any and all persons and to any and all property, in any way sustained or alleged to have been sustained, as a result of the participant(s) engagement in the activities of the Program. This release is effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives, in the event of my death or incapacity.
By Signing below, I consent to having the information in this document collected by Centre Street Church. This personal information in being collected for the purpose of enrolling your child(ren) in the Program, to assign the child(ren) to the appropriate classes, to develop and nurture ongoing relationships with you and your child(ren) and to inform you of Program updates and upcoming opportunities at our church. Your personal information is protected under the Personal Information Protection Act in the Province of Alberta.