RISING STUDENTS MEDIA/MEDICAL RELEASE 2022/23

In order to ensure that your student is well cared for at all of our events and trips, we ask that each family fill this form out biennially, or whenever medical insurance needs to be updated.

EMERGENCY CONTACT

In case of emergency and the parents or guardians listed above cannot be reached in a reasonable period of time, the individuals listed below may be contacted, given notification of the emergency, and be authorized to provide instructions for actions to be taken.



**This should be someone other than the parents or guardians listed above.

RELEASE OF LIABILITY

I acknowledge and understand there are inherent risks associated with many RISING Students activities. I will assume the risks associated therewith, whether known or unknown to me at this time. I recognize that my child’s attendance at a RISING Church-sponsored event is a privilege and as a consideration for this privilege, I release RISING Church, including its employees, agents, and trustees, from responsibility for my child’s accidental physical injury, including death, sickness, and exposure to an infectious communicable disease while at a sponsored trip or activity or during travel to and from events. This release is intended to include all claims made by my family, estate, heirs, personal representatives, or assigns.

MEDIA CONSENT

I hereby grant permission to RISING Students and RISING Church the right to take, use, reproduce, and/or distribute photographs, films, video, and sound recordings of my child, without compensation or approval rights, for use in materials created for purposes of highlighting, documenting, and promoting the activities of RISING Students.

PARENT COVENANT

I grant authority to the RISING Students leadership for any necessary and appropriate, non-physical discipline of the above-named student(s), including removing the student(s) from programs, activities, and trips, if necessary. In the event a serious behavioral incident does occur with a child named above on any trip or activity, the leadership team will assess the situation, make a decision, call the parent and give options to what action will then take place including removing the student(s) at the parent’s expense. Examples may include but are not limited to, fighting, vandalism, violent behavior, and possession/use of drugs and/or alcohol.

FIRST AID AND EMERGENCY MEDICAL TREATMENT

I recognize that there may be occasions where the student(s) named above may be in need of first aid or emergency medical treatment as a result of an accident, illness, or other health condition or injury. I do hereby give permission for agents of RISING CHURCH to seek and secure any needed medical attention or treatment for the student(s) named above, including hospitalization if in the agent’s opinion such need arises. In doing so, I agree to pay all fees and costs arising from this medical treatment. I also give permission for attending physician(s) and other medical personnel to administer any needed medical treatment and again, I agree to pay for the medical treatment.

AUTHORIZATION TO PARTICIPATE

I represent that I am the parent/ guardian of the above-named student(s). I have read the above form and am fully aware of the contents thereof. I give permission for the above-named student(s) to participate in the activities of RISING Church, including any special events. I consent on behalf of the above-named student(s) to the Emergency Treatment Authorization and other agreements as indicated above. Furthermore, I understand that my signature below certifies that the information contained herein is accurate and truthful.

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