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PARTICIPANT PERMISSION AND RELEASE OF LIABILITY
In order for my child to participate in activities sponsored by Cornerstone Church
of God, I understand that I will be responsible for any medical expenses for myself and my dependents, if any, and to waive
any legal right or claim against Cornerstone Church of God, its staff, members or directors that I might have as
a result of injury incurred by participation in any such activity or travel to and from any such activity.
I understand and acknowledge that by signing this form I am authorizing any staff
member, if in their sole discretion it is necessary, to administer first aid, contact a physician for medical treatment, summons
emergency medical care, and/or to transport me/my dependent to a medical facility for treatment.
Parent or Guardian
Work or Cell