Liability release

As a parent and/or guardian, I do herewith authorize treatment, under the direction of any licensed physician, for the below named minor(s) in the event of a medical emergency which, in the opinion of the attending physician, may endanger his or her life, cause disfigurement, physical impairment, or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me by phone at the number listed. The undersigned assumes the responsibility for any costs connected with such treatment and hereby releases the First Baptist Church of Avoca from any liability therefore. This release form is completed and signed of my own free will with the sole purpose of authorizing medical treatment under emergency circumstances in my absence.

I consent to the use of recorded media of my family for online and print by First Baptist Church of Avoca, NY.

Avoca TKD registration