2019 VBS Application for Youth Leader

I, the undersigned, do hereby agree to release, discharge, and hold harmless China Grace Christian Church, its officers, agents, and employees of and from all causes, liabilities, damage, or demands whatsoever on account of any injury or accident involving my attendance with the VBS program from August 19 to August 23, 2019 and participation in the activities particular to this program. I hereby authorize a physician(s) selected by the program, or the emergency/outpatient department of the most appropriate hospital to provide such care that includes routine diagnostic procedures and medical treatment as necessary. I give permission for the program staff at China Grace Christian Church to provide first aid. A photocopy of this authorization shall be considered as effective and valid as the original. I understand this consent is valid only during the stated dates of the program.