Medical Acknowledgement and Release
This aforementioned registration information and health history is true and correct to the best of my knowledge. I hereby give my full consent to Berean Community Church and its officers to seek and administer treatment for any injuries and/or illnesses that I might sustain while participating in the BCC activities and while under supervision as a participant in said activities, including transportation to and from any facilities necessary for proper treatment. I understand that Berean Community Church will select a qualified physician, nurse, dentist, or other certified medical professional to administer treatment.
As a participant, I understand that Berean Community Church is not obligated to carry any insurance to cover those medical and/or dental expenses. If such insurance is carried, coverage will be provided only for expenses in excess of the limits of the participant’s existing insurance coverage. I understand that my personal health insurance is my primary coverage for all occurrences while participating in BCC functions.
I desire to participate in the activities at Berean Community Church. In consideration of Berean Community Church providing these activities, I do hereby release Berean Community Church, its officers, employees, agents, and members from all claims and causes of action by reason of any injury or illness which may be sustained as a result of these church activities, whether on church premises or on the way to or from these activities.
This authorization shall remain effective until revoked in writing and delivered to Berean Community Church.