Faith Week June 10-14, 2022 $270 per person
Medical Information and Release
In event of emergency notify:
TO BE COMPLETED BY PARENTS/GUARDIANS-MEDICAL, SURGICAL AND LIABILITY WAIVER. The person described on this registration form has my permission to be in all FAITH WEEK activities at the place named herein and on the dates named herein, except as noted by me. If a medical emergency should arise while my child or ward is at FAITH WEEK or in transit to FAITH WEEK and I cannot be reached, I consent and give my permission to the trip director or representative of FAITH WEEK to select a physician and/or hospital for my child's or ward's care. I also give the physician and/or hospital, as selected by the trip director or representative of FAITH WEEK, my permission to hospitalize, treat, give x-rays, tests and to order injections, anesthesia, or surgery for my child who is named herein, which may in their sole discretion be necessary and proper under the circumstances. I do release, acquit, discharge and covenant to hold harmless the EASTWOOD BAPTIST CHURCH, TULSA, OK, its representatives, the trip director or FAITH WEEK staff, of any and all actions, damages, or liabilities arising out of the treatment of any sickness, or accident incurred by my said child or ward during the dates listed herein at FAITH WEEK. I authorize said physician or any physician or hospital who has previously treated my child or ward to disclose any information there acquired, if requested. I understand that in the event of a medical emergency requiring medical care, as I have authorized below, all costs for such emergency and subsequent medical care ARE MY RESPONSIBILITY and I agree to make payment of all such medical costs. I understand that I will be notified of the rendition of medical care, and that I must notify my insurance carrier.
I hereby grant EBC Faith Week Camp Staff permission to photograph my child in pictures depicting daily camp activities and unique learning opportunities with the same permission extended for using these pictures in camp promotions, videos, etc., demonstrating the Faith Week Experience.
