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Please read the required releases below and agree to terms listed on participant sign up form.

Emergency Care/Medical Release

I, the undersigned parent/guardian, do hereby grant permission for my son/daughter, named on this registration, to receive the proper medical treatment in the event that s/he may sustain injury or illness while attending an activity at Central United Methodist Church in Lenoir City. I hereby authorize the Central staff/volunteer to obtain or provide medical treatment for my son/daughter for such injury or illness.


The Central staff/volunteer has my permission in an emergency to take my son/daughter at my expense, to the hospital emergency room deemed appropriate by the rescue squad or adult advisor(s). The hospital and its medical staff have my authorization to provide treatment, which a physician deems necessary, including anesthesia, for the well-being of my child. I understand every effort will be made to contact me in such a situation. This agreement is effective from June 1, 2018 to May 31, 2019.


Image Release

I understand that my child(ren) may be photographed and/or videotaped during activities at Central United Methodist Church. I give permission for these images to be used in print, video, and digital media, including use on the CUMC website. This permission is valid until revoked by me in writing.


Security Agreement

Each family participating in VBS will receive a security card that shows your child(ren)’s information. The VBS staff will release a child to anyone who presents the proper security card. It is imperative that parents/guardians protect the cards and give them only to people authorized on this form to pick up their child(ren). The VBS staff will release a child to anyone who has that child’s security card. We are willing release a child upon presentation of picture identification for anyone listed as able to pick up on the child’s registration form.  

I understand the security mechanism being used to protect my child and agree to fulfill my responsibility of protecting the security card, presenting picture identification when requested, and informing the  VBS staff of anyone who may not pick up my child(ren).

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