Medical & Surgical Waiver

Adult Sponsor 2021

hereby enter into this waiver with regard to any travel or participation in church-sponsored events and functions of Green Acres Baptist Church from January 1, 2021 through midnight, December 31, 2021. In the event there arises an emergency necessitating emergency medical or surgical attention, and in the event that I am for whatever reason incapable of making such determination, I hereby consent and give permission to Green Acres Baptist Church, or its representatives, or any attending physician to make such decisions and to perform such medical or surgical treatment upon me, which in their sole discretion, may be reasonable and necessary under the circumstances.
I, the undersigned, do release, acquit, discharge, and covenant to hold harmless the said Green Acres Baptist Church or its representatives from any and all actions, damages, and/or liabilities arising out of the treatment of any sickness or accident incurred by me. It is the intention of this release that Green Acres Baptist Church and its representatives incur no liability whatsoever while attending to the reasonable and necessary treatments, surgery, and other medical needs that may in their sole discretion be needed by me.

Health Form

Medical Insurance