Broad Street Presbyterian Consent
I/We do hereby give permission for my/our child to attend and participate in The Pilgrimage summer trip to Church of the Pilgrims, Washington, D.C. from June 9-14, 2019.
In the event of an emergency, I/we do also hereby give permission to the adult leaders as representatives of Broad Street Presbyterian Church to act in my/our behalf to consent to any medical treatment or hospitalization deemed necessary by the leaders and a licensed physician or emergency team. I/We agree to be liable to any and all costs involved in such emergency treatment. I/We release and discharge Broad Street Presbyterian Church and/or representatives involved in this activity from any liability in exercising this permission. The health information on this form is true to the best of my/our knowledge and I/we give permission to the leaders to dispense medications as directed and indicated on this form to my child.
Pilgrimage Liability Release Form
In consideration of the acceptance of my registration, for myself, administrators, and assignees do hereby forever release and discharge The Pilgrimage, of Church of the Pilgrims (PCUSA), and all other affiliates, sponsors, and subsidiaries of all claims and damages, demand and actions whatsoever in any manner arising out of my participation in The Pilgrimage programs. I attest and verify that I have full knowledge of the risks involved in this event, and I am physically fit to participate in Pilgrimage programs. Further, I hereby grant full permission to any and all of the foregoing pictures, recordings, and any other record of this event for legitimate purposes (i.e. Pilgrimage web site) without compensation or renumeration.
Parent or Gaurdian's Signature:
Participant's Signature (both adult and youth):
Today's Date: September 22, 2019