Medical Release Form Entry

Parent Information

Emergency Contact

I give permission for first aid techniques and simple health care to be administered as the need arises. I understand in the event of any serious injury or illness the nurse / Children’s Staff / HUB staff / camp officials reserve the right to seek professional medical attention including but not limited to consultation with medical director, EMS transportation, and hospitalization.

I give my child / student permission to attend the activities and functions sponsored by Houston's First Baptist Church Children’s Ministry and/or Houston’s First Baptist Church Student Ministry. I authorize Houston’s First Baptist Church, its agents or employees, to provide such medical care treatment, as may be necessary, in their judgment, during activities and events and such transportation.

In consideration of myself or my child being permitted to participate in HUB Student Ministries Activities (collectively referred to as "Activity"), including travel to and from the event site and for services of First Baptist Church of Houston (“Church”), their respective agents, employees, trustees, officers, directors, volunteers, sponsors, successors and assigns, and all others acting in any capacity on their behalf (collectively referred to herein as the “Releasees”) to conduct any Activity, In regard to my personal rights, I hereby agree to release, discharge, indemnify and hold harmless church, against all losses, liabilities, claims, demands, suits, damages, costs and expenses including, but not limited to, court costs and attorney fees directly or indirectly arising out of any property damage or loss, bodily injuries, sickness, disease or death in connection with or arising out of activity. I do so on behalf of myself, my spouse, my nonparticipating children, my parents, my heirs, assigns, personal representatives and estate.

I acknowledge that engaging in off-site Activities entails both known and unknown risks that could result in illness including COVID-19, severe physical and emotional injury, paralysis, death, or damage or loss of property. These risks include but are not limited to: accidents in the course of travel to and from the destination; risk of injury or illness associated with automobile, van or bus travel, activity around camp or bonfires, off-site scavenger hunts, youth athletic competitions such as volleyball, basketball, or football or creative variations of each.

I understand that I am ultimately responsible for investigating and assessing all risks involved. I agree to assume all risks associated with activity, whether known or unknown, foreseeable or unforeseeable. I specifically agree to accept and assume the risk that Releasees or other third parties may commit negligent acts or omissions during the Activity. I also agree to accept and assume the risk that any injuries or illness I or my child may suffer during Activity may be made worse by negligent treatment or rescue efforts by Church or other third parties.