I give full permission for my child to attend and participate in any youth activity sponsored by Christ Church Cranbrook between September
1, 2016 and August 31, 2017.
DURABLE POWER OF ATTORNEY FOR EMERGENCY MEDICAL/SURGICAL CARE:
I represent and warrant that to the best of my knowledge my child has no illness, congenital defect, or other health condition that makes my child’s participation in Christ Church Cranbrook youth activities unsafe for my child or other participants even with reasonable accommodation of any disability.
I appoint Christ Church Cranbrook (470 Church Road, Bloomfield Hills, MI 48304) as my agent pursuant to MCLA 700.5103 for the limited purpose of consenting to any emergency medical or surgical care for my child that may be recommended by a physician regarding any injury or illness that may arise while my child is participating in a Christ Church Cranbrook youth activity. Christ Church Cranbrook shall use its best efforts to contact me in advance of exercising this delegated power so that I may direct my child’s care. If I am unavailable after reasonable attempts to contact me, or if my child’s condition makes any delay medically unadvisable, then Christ Church Cranbrook may exercise the delegated power without communicating with me first.
I agree to pay all health care providers for any services rendered to my child pursuant to this delegated power, whether through health insurance or private payment.
I give full permission for my child/children to be transported to Christ Church Cranbrook youth activities between September 1, 2016 and August 31, 2017, which includes permitting my child to attend and participate in activities off site of the Christ Church Cranbrook campus.
WAIVER OF LIABILITY:
I release Christ Church Cranbrook, its agents, employees, officers, vestry members and volunteers, from any liability of any kind or nature that may arise in any way from my child’s participation in Christ Church Cranbrook youth activities.
I give permission for photographs or video of my child or myself to be taken during my child’s or my participation in Christ Church Cranbrook youth activities, to be used by Christ Church Cranbrook for promotional purposes.