I, the undersigned, being the parent or legal guardian of the youth named above, do hereby consent to my child participating in local Mosaic Youth activities, which include, but are not limited to a 40-mile radius of Highland, IL, which includes transportation to/from the event sites. I, as parent or legal guardian of the child listed above, believe that the necessary precautions and plans for the care and supervision of the student during this year will be taken. In case of an emergency, I understand that the youth leaders of Mosaic Church will make every effort to contact me or an adult listed above. In the event that none of the above can be reached, I hereby give my permission to the licensed healthcare provider selected by Mosaic Church leadership to secure proper treatment, including related transportation, hospitalization, anesthesia, surgery, or medication for my child. I do, hereby, release Mosaic Church and all volunteers associated with weekly meetings and youth trips from any and all claims, loss, cost, damage, liability, or expense arising out of or from any accident or other occurrences causing injury to any person or property. I, as parent or legal guardian of the child listed above, hereby agree and declare that I have carefully read and understand the general provisions, understand its contents, and agree to its terms and conditions.
