WAY Everything Form

I hereby give permission for images and videos of my student that may be captured during their experiences to be used for the purpose of Washington Alliance training, promotional material, and publications and waive any rights of compensation or ownership thereto. (If your student is not permitted to have his/her photo taken for these purposes, do not check this box.)

I, the undersigned parent or guardian of the above student, a minor, do hereby authorize adult workers with the youth of Washington Alliance Church to consent to any examination, x-ray, anesthetic, medical or surgical diagnosis or treatment and hospital care which is rendered under supervision of any physician or surgeon licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. Further, as parent or guardian of the minor named above, I do hereby expressly consent that my son/daughter may receive emergency medical treatment from any physician, hospital, or other medical center without the necessity of notifying me, and do further agree to hold blameless any physician, hospital, or other medical center for rendering such services. I also release The Christian & Missionary Alliance staff and volunteers from liability resulting from any accident.