2019-2020 Parent Contact Form

For all OCC participants age 17 and under.

Good for all OCC activities June 1, 2019 - June 30, 2020
Youth/Child info

 
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Grade in 2019-2020 school year
 
 
 
 
 
 
 
 
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Adult contact info

 
 
 
 
 
 
 
 
TO WHOM IT MAY CONCERN: The undersigned does hereby give permission for my (our) child, named above, to attend and participate in activities sponsored by OAKLAND CHURCH OF CHRIST. It is my (our) understanding that this consent and authorization covers any and all activities, at the church building and away from the church building, between June 1, 2018 and June 30, 2019. I (We) authorize an adult, in whose care the minor has been entrusted, to consent to any X-ray, examination, anesthetic, medical, surgical or dental diagnosis or treatment, and hospital care, to be rendered to the said minor under the general or special supervision, and upon the advice of any licensed physician or dentist. Should it be necessary for my (our) child to return home due to medical reasons or otherwise, the undersigned shall assume any and all transportation and related costs. The undersigned further agrees and does hereby give permission for my (our) child to ride in any vehicle designated by the adult in whose care the minor child has been entrusted while attending and participating in activities sponsored by OAKLAND CHURCH OF CHRIST. In addition, the undersigned shall hold OAKLAND CHURCH OF CHRIST, its assigns, employees, and officers harmless with respect to any and all costs and expenses and with respect to any claim or assertion and liability, arising out of the conduct of my (our) minor as said minor may be involved in the activity being sponsored by OAKLAND CHURCH OF CHRIST. More specifically, I (we) agree to indemnify OAKLAND CHURCH OF CHRIST, its assigns, employees, and officers for any injury to person or damage to property resulting from the conduct of my (our) child.


 
 
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Description

For all OCC participants age 17 and under.

Good for all OCC activities June 1, 2019 - June 30, 2020