Parental Consent / Release from Liability

I/We, the undersigned parent(s) or guardian(s) of ____________________________ , a minor, consent to him/her participating in a voluntary mission trip to ___________ organized by _______________ Church of __________ scheduled for _______, 200_ (mission trip). I/We release and discharge each of the participating churches, their officers, employees and all organizers of the mission trip from all claims, damages, or losses of any nature that: 1) I/we may have or acquire as the parent(s) or guardian(s) of the above-named minor from him/her voluntary participating in the mission trip; and 2) the above-referenced minor may have arising out of or resulting from his/her participating in the mission trip.

I/We authorize adult participants in the mission trip to act on our behalf in authorizing and consenting to emergency medical care for the above-referenced minor if he/she becomes ill/injured while participating in the voluntary mission trip. This consent may be presented to the appropriate medical emergency medical staff at the time emergency medical care is required. I/We release and discharge the participating churches, their employees, organizers of the mission trip, and adult participants in the mission trip from any claims of any nature that may arise out of the decision to provide emergency medical care.

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Signature(s) of Parent(s) or Guardian(s)........................ Relationship .......................... Date........