I verify that I am the Parent or Legal Guardian of the above mentioned minor(s). I authorize the officers, agents, volunteers and/or employees of Severna Park Baptist Church (SPBC) to take the necessary steps to ensure prompt and necessary medical care at my sole expense for the above named minor in the event that he/she becomes ill or sustains injury while on ALL EVENTS.  I give my permission to the officers, agents, volunteers and/or employees of SPBC to spot any bleeding and to administer first aid on the above named minor.  I also consent to any X-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment, and hospital care to be rendered to the above named minor under the general and specific supervision and on the advice of any duly licensed physician, surgeon or dentist while on the trip.

I hold harmless and fully and forever release and discharge SPBC, all officers, agents, volunteers and/or employees of SPBC from any and all claims, demands, damages, rights of action, present or future whether the same be known, anticipated or unanticipated, and resulting from or arising out of, or incident to the providing of this medical assistance.

I will be liable and agree to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child pursuant to this authorization.

Should it be necessary for the above named minor to return home due to medical reasons, behavioral problems, or otherwise, I will provide or assume all transportation costs.