Vacation Bible School Terms and Conditions

I give permission for my Student(s) to participate in Shiremanstown First Church of God’s
“VBS Safari”. I hereby release Shiremanstown Church of God, its staff, volunteers, and
sponsors, from responsibility and liability for any injury or illness that my student(s) may
sustain during any activity. In the event of an emergency, I hereby authorize an adult leader
of this activity, as agent for me, to consent to any X-ray examination; medical, dental or
surgical diagnosis; treatment; and hospital care advised and supervised by a physician,
surgeon or dentist (as appropriate) licensed to practice under the laws of the state where
the services are rendered, either at a doctor’s office or in any hospital; in my absence. I
expect to be contacted as soon as possible.