I HEREBY GIVE PERMISSION to the above named MINOR to travel and/or participate with Lighthouse Youth at the
EVENT: Radical Reality Summer Camp (Donnie Moore), Richardson Springs, CA
DATE: Monday-Friday, July 23-27, 2018
IN THE CASE OF AN EMERGENCY, I hereby give permission to Lighthouse's program DIRECTOR(S) or assistants to act on my behalf for said MINOR, including granting permission for evaluation and treatment of medical problems.
If I cannot be reached, I hereby give my consent to such medical treatment as deemed necessary, including permission to the PHYSICIAN and/or HOSPITAL selected to hospitalize, secure proper treatment for, order injection, anesthesia, x-ray examinations, or surgery to be rendered to my CHILD by a licensed physician or nurse.
I, the PARENT/GUARDIAN of the above named CHILD, do hereby release LIGHTHOUSE CHRISTIAN CHURCH (LCC), its agents, employees, and volunteer assistants from any liability whatsoever arising out of any injury, damage or loss which may be sustained by my MINOR during the period of involvement with LCC events.
All photography or videos of the MINOR during Lighthouse event activities remains the sole property of LCC, and LCC reserves the right to use all media obtained in any LCC audio/visual/printed materials.