High School, grab your friends and throw on your boots - we're celebrating fall right with a trip to the pumpkin patch! We're meeting up at the Office, then heading to Johnson Farms for an afternoon of hay rides, picking out pumpkins, and hangin'. All you need to bring is a sick flannel, $10 for activities at the farm, and your crew. See you there!
Please carefully fill in all required boxes with the correct information or the form will not process. Thank you.
AUTHORIZATION TO CONSENT TO MEDICAL TREATMENT OF MINOR CHILD
In the event that a serious accident or illness befalls your child, Ekklesia Church will first make every effort to contact you at home or place of business to comply with your instructions. If you cannot be located, Ekklesia Church is authorized to:
- Contact the family physician or alternative names listed above and follow their instructions.
- Transport the above child to a local hospital for treatment by emergency room physician on duty.
- The undersigned hereby authorize physician named to give consent for any procedure or hospital care deemed advisable by said doctor. In the event that the doctor is not available, Ekklesia’s leadership is authorized to give necessary consent for any treatment, care, diagnosis, and/or examination of the person named.
I hereby release Ekklesia Church, its employees and agents from all liability whatsoever for any injury, damage, or loss which may be sustained by my child during the course of involvement with Ekklesia Church.