Professional Documents
Culture Documents
I hereby release Harbor Covenant Church, its staff and sponsors, from responsibility and liability for any in-
jury and illness that my child may sustain during this activity. In the event of an emergency, I hereby author-
ize an adult leader of this activity, as an agent for me, to consent to any x-ray examination; medical, dental
or surgical diagnosis; treatment; and hospital care as advised by a physician, surgeon or dentist (as appro-
priate) as listened to practice under the laws of the state/province where the services are rendered, either
at the doctors office or in any hospital. I expect to be contacted as soon as possible.
I also understand that if my child is disruptive, brings alcohol, drugs, weapons, causes any injury to them-
selves or others, or engages in any unacceptable behavior, I will be responsible to remove my child from this
activity and transport them immediately back to Gig Harbor.
___________________________________________________ __________________
Parent or Legal Guardian Date
Harbor Covenant Church, 5601 Gustafson Dr. NW, Gig Harbor, WA 98335, 253.851.8450
For more info please contact: Jen Easton,
Director of Middle School Ministries at Harbor Covenant Church
Office: 851-8450 or jeaston@harborcovenant.org