Medical & Liabilities Release Form

*Please note that completed forms expire after 1 year.*

In order to keep our students happy and safe, we need some helpful information from you. Please fill out the fields below for our records. Please complete one form for each student.

  • MM slash DD slash YYYY
  • By submitting this form, you confirm that you are the parent or guardian of the student for whom this form is completed, or are the student and are over age 18. By submitting this form, you are also agreeing to the following statements: In the unlikely event that I or my appointed emergency contact cannot be reached in an emergency while my student is with Bridges Community Church, I hereby give my permission to the physician selected by the Bridges Community Church supervisors to hospitalize, to secure proper treatment, and/or order an injection, anesthesia, or surgery for my student as deemed necessary. I understand that all billings for services rendered will be sent to me as the parent/legal guardian and that I am responsible for the complete payment. In the unlikely event that my student is injured while participating in activities on or off the campus of Bridges Community Church or in route to such activities, my student and I relinquish all rights to recover damages for any and all injuries sustained by my student during or in route to activities. I acknowledge that if my student has to return home early for discipline violations, it will be at the parent/guardian’s expense. I also understand that photos and videos may be taken of my student while at Bridges Community Church events, which may be used by Bridges Community Church for future promotional purposes.
  • This field is for validation purposes and should be left unchanged.