I hereby certify that I am aware of, approve of, and take full responsibility for the participation of the above named Participants in The Congregational Church of Needham’s 2014-2015 Youth Choir Programming. Furthermore, I assume all risk of and financial responsibility for any loss or injury to the youth or others that may occur as a result of negligence or misconduct by the youth, and I release the Church, and its employees, volunteers, and other agents, from any and all responsibility and legal liability for loss, damage, or injury to the person or property of the Youth which may be sustained during or as a result of participation in the Youth Choir.
In the event of an emergency, including illness, injury, or incapacity suffered by the Youth during the course of the programming, I hereby authorize the Youth Choir Leader, a chaperone, or any other adult leader to act as agent for me in consenting to any reasonably necessary X-Ray examination, medical, dental, surgical, or psychological diagnosis, treatment, and/or care, advised and supervised by a physician, dentist, surgeon, psychologist, or social worker licensed to practice under the laws of the state in which the services are rendered. I understand that I, or the applicable insurance carrier(s), will be financially responsible for any such emergency services. I expect that attempts will be made to contact me in the event of any such emergency.