Please note that any question with an asterisk (*) must be completed in order to submit the form.

I desire for my child / children (names listed above) to participate in the Care and Rescue Center of York County dba CATAWBA TERRACE CARE CENTER / KIDS CLUB (KIDS CLUB) activities and give my permission do so. I further authorize KIDS CLUB and Westminster Presbyterian Church (WPC) and its volunteers, staff, and agents to provide first aid to myself and child/ward in accord with their judgment. In the event that myself and/or my child/ward, in the opinion of KIDS CLUB and WPC or its volunteers, staff, or agents, needs medical care beyond first aid, I give my consent and permission for medical care to be obtained on behalf of my child / ward and further give consent to any treatment recommended the medical personnel consulted. I give permission for my child / ward to be photographed and / or videoed and for KIDS CLUB and WPC to use the images for its digital assets (social media, websites).

I understand that KIDS CLUB activities may include travel provided by KIDS CLUB and WPC vehicles and/or personal vehicles, trips to and participation in activities including, but not limited to, amusement parks, restaurants, swimming, sports/games and/or other potentially dangerous activities. I freely and voluntarily assume risk of personal injury, even if the result is the negligence of the Kids Club and WPC or its volunteers, staff, or and further release and hold harmless KIDS CLUB and WPC and its volunteers, staff, or agents, and further release and hold harmless KIDS CLUB and WPC and its volunteers, staff, and agents with respect to any and all injury, disability, death, or loss or damage to person or property, whether caused by the negligence of the releases or otherwise. I UNDERSTAND I AM GIVING UP IMPORTANT LEGAL RIGHTS BY SIGNING THIS DOCUMENT.