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Creekside Kids Waiver

My child has my permission to attend and participate in the Creekside Kids program running on Wednesday evenings (from 6:30pm to 8:00pm) at Stoney Creek Baptist Church, London. The undersigned further authorizes Stoney Creek leaders, workers, and volunteers to grant permission for medical or dental treatment during the said time period in the event that the parent/parents or legal guardian/guardians are unable to provide such consent.  Furthermore, the undersigned shall be liable and agrees to pay for all costs and expenses incurred in connection with such medical and dental services rendered to the said Child pursuant to this consent. The undersigned, on behalf of themselves and the said Child do hereby release and forever discharge the Church and its Deacons, Pastors, Officers, Employees, Volunteers, Members, and Adherents against all losses, claims, suits, and demands, or any liabilities whatsoever, arising from injury or death to the Child or other persons involved in the above mentioned activity.  The undersigned agrees, also, to allow photos and videos of said child to be used for church promotional materials, unless otherwise indicated to a Creekside worker.