Student Medical Release/Event Submission

Please submit one student per form.

I give permission for the above named participant to participate in the youth programs of Ironbridge Church Student Ministry.  I consent to James Wilson or a leader designated by him to obtain and consent to any medical and/or surgical needs of my child based on urgent need: understanding effort to contact me or other emergency contacts will be made but is not a prerequisite to urgent medical care.  I accept full financial responsibility for my child's participation during these activities including any costs that may arise due to medical treatment of my child.  I also consent to having read the bridge's guidelines for conduct and made the named participant aware of them.  I do release, discharge and exonerate Ironbridge Church of Chester, Virginia and all persons acting as chaperones or sponsors on trip-related activities from all liability whatsoever, except where persons have been grossly negligent, resulting in the personal injury to the above minor or damage to property of the minor which may occur on a trip or in connection therewith.  I have read the above waiver/release and understand that I have given up substantial rights by signing this release and sign below voluntarily.  In signing, I admit to having authority to sign for the named participant and recognize the authority of this contract.

 

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Latest sermon

Essentials: A Heart For Worship by

Pastor

Dr. Gary Threatt