Authorization for Medical Treatment: In the event I cannot be reached in an emergency, I hereby authorize the physician selected by me to assist Wilkesboro Baptist Church ("WBC") with hospitalizing, securing proper medical and/or dental treatment and/or order an injection, anesthesia, or surgery for my child as deemed necessary. I also authorize WBC to administer medical aid as required for illness or injury under a physician's orders.

Assumption of Risk: I am aware that no church activities are without the possibility of unforeseen hazards. I understand that certain activities have the inherent possibility of risk and it is impossible to list all such risks. I am aware that church activities, including recreation, crafts, and projects ("the ACTIVITIES") are potentially hazardous. I am voluntarily allowing my child to participate in the ACTIVITIES with the knowledge of the possibility of danger involved, and hereby agree to accept any and all risks of injury or death to my child, and verify this statement by clicking below.

Liability Release: As consideration of WBC permitting my child to participate in the ACTIVITIES, I hereby agree that l, my assignees, heirs, distributees, guardians, and legal representatives will not make claim against, sue, or attach the property of WBC, any of its affiliated organizations, or any of its employees, volunteers, or agents for injury, death, or damage resulting from the negligence or other acts, howsoever caused, by any employee, agent, or contractor of WBC or any of its affiliated organizations as a result of my child's participation in the ACTIVITIES. I hereby release WBC, its affiliated organizations, its employees, volunteers, and agents from all actions, claims, or demands that I, my assignees, heirs, distributees, guardians, and legal representatives now have or may hereafter have for injury or damage resulting from my child's participation in the ACTIVITIES. I further acknowledge and agree that WBC shall not be liable for any injury, death, damage to my child resulting from any activity in which my child participates which is outside of the scope of those ACTIVITIES that are sponsored and sanctioned by WBC. 

Photo Release: I give permission for my child to be photographed and/or videotaped for future promotional materials including web site postings. I do so without expectation of compensation and with the understanding that these photographs and video images will be used exclusively by WBC for its publications, web site, and publicity purposes. 

Potential Claims Not Covered By This Release: I understand that, pursuant to North Carolina law, by executing this RELEASE FROM LIABILITY, I am not waiving my rights or my child's rights with regard to any potential claims that may arise from the fraudulent, intentional, and/or criminal conduct of WBC, any of its affiliated organizations, or any of its employees, volunteers, or agents.

Knowing and Voluntary Execution: I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability and a contract between me and WBC. I sign it of my own free will.