Please take a moment to fill out the form.
By initialling below, I do hereby give permissions for my adult to attend and participate in activities sponsored by WAVES of First Baptist Church. I understand that students will be transported by a staff member of WAVES in a van to and from activities during the day.
I agree to assume the risk of, and release WAVES of First Baptist Church, its staff and representatives from, any and all injury and liability arising out of or relating to the activities conducted or sponsored by WAVES of First Baptist Church.
Permission Clause: In the event that my adult becomes ill or sustains an injury while on an authorized and chaperoned outing with WAVES of First Baptist Church of Wilmington, I give my permission to the staff or representatives of WAVES DAY PROGRAM to administer first aid and/or take my child to the nearest medical facility for additional treatment. I will not hold WAVES of First Baptist Church of Wilmington or any chaperone personally or financially responsible for any accident or illness that may occur.
Medical Insurance Agreement: I hereby confirm that the participant is covered and will remain covered under a policy of medical insurance with the company and the policy and group numbers are listed above. If my coverage changes to another company, I will promptly notify WAVES at 910-617-1536. I further agree that my insurance company will be the primary source of coverage in case of injury or accident held at or sponsored by WAVES of First Baptist Church involving my child, and I am responsible for any deductible expenses in connection with that coverage. By initialling below, you are agreeing to assume all responsibility for doctor bills other expenses related to an emergency.
Media Release Agreement: I further understand that photographs or video recordings may be created during the day at WAVES Day Program, and I give permission for WAVES First Baptist Church of Wilmington to use any or all recordings of my child in publications, videos, website design or other media expressions. I waive all rights to control any aspect of these photographs and recordings.
