Worship: A cappella, 8:45 AM | Instrumental, 11:15 AM
Growth Groups: 10:00 AM

Medical Release Form

Medical Release Form
  • I, the Parent or Guardian of the above child, do hereby request that the above named child be permitted to attend youth activities sponsored by the Westover Hills Church of Christ in the calendar year 2016. I agree and consent to having staff members, counselors and activity sponsors secure any emergency medical care of treatment that may be necessary for my child during the entire outing, including the trip to their destination and the trip back home from it. I release the staff members, counselors, activity sponsors and Westover Hills Church of Christ from any liability connected with injury or cost of medical treatment. I further assume all responsibility for the decisions so made and for the emergency care or treatment so secured for my child.

  • We, the undersigned parent(s) or guardian(s) of a minor, do hereby authorize an adult staff member, counselor or activity sponsor of the Westover Hills Church of Christ, as agent(s) for the undersigned, to consent to any examination, x-ray, anesthetic, medical or surgical diagnosis or treatment and hospital care which is rendered under supervision of any physician or surgeon licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital.