I, the undersigned parent or guardian of this registered student, a minor, do authorize any duly authorized employee, volunteer, or other representative of Little Lakes Wesleyan Church, as agents of the undersigned to consent for any x-ray, examination, anesthetic, first aid, medical, or surgical diagnosis or treatment and hospital care deemed advisable by and is to be rendered under the general or specific supervision of any licensed physician and surgeon, whether such diagnosis or treatment is rendered at the office of said physician and surgeon or at a clinic, hospital, or medical facility. It is understood that this is given in advance of any specific diagnosis, treatment, or hospital care being required, but it is given to provide authority and power on the part of the aforesaid agent(s) to give specific consent to any and all such diagnosis, treatment, or hospital care which aforementioned physician in the exercise of his or her best judgment may deem advisable. It is understood that all costs of all medical treatments/care and or emergencies will be paid for by the parent or legal guardian.
I, the undersigned parent or guardian of registered student, a minor, do authorize any duly authorized employee, volunteer or other representative of Little Lakes Wesleyan church as agents of the undersigned to dispense medication to my child.
My child will need the following medication during this event:_______________________________________
I hereby grant permission for Little Lakes Wesleyan Church to record sounds, images, or video of the above registered child while attending Wonder Junction VBS. I also give permission for Little Lakes Wesleyan Church at its sole discretion, to use these sounds, images, or videos in publications (including print, websites, and social media platforms) owned by Little Lakes Wesleyan Church in relation to Wonder Junction VBS.
