I hereby request and authorize Oasis Youth Ministries, OCCM. hospitals, licensed medical or dental providers. and their agents and employees to have access to the information contained in this form and to provide all medical or dental care. routine tests, treatment, and necessary transportation advisable for the health and safety of my child. This authorization includes the authority to consent to any x-ray examinations, anesthetic. medical procedure or treatment. and hospital care under the supervision. and upon the advice of or to be rendered by, a physician or surgeon licensed under the Medical Practice Act or dentist licensed under the Dental Practice Act for my child.
I further authorize the Director of Youth Ministries or a designated adult representative of the OCCM to receive physical custody of my child upon completion of any treatment. and I specifically instruct any treating health facility to surrender physical custody of my child to said adult.
I understand that participation in the above Activity or Event may be hazardous for the above-named participant. In signing below, I assume risk of harm or injury which may occur to the participant as a result of participating in the above-named event or activity. I hereby release Oasis Community Church Muskogee and its officers. employees, or agents from any liability, costs, and damages to (or caused by) the individual (or to personal belongings) resulting from this individual's participation.
I grant permission to Oasis Community Church Muskogee (OCCM) and its subordinates (departments/staff), to use my name, quotes, photographs and/or videos for use in OCCM publications such as recruiting brochures, newsletters, magazines, display boards, and in electronic versions of the same publications or on the OCCM web site or other electronic forms or media. Ihereby waive any right to inspect or approve the finished photographs/videos or printed or electronic matter that may be used in conjunction with them now or in the future. whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the photograph. I hereby agree to release. defend, and hold harmless OCCM and subordinates (departments/staff), including any firm publishing and/or distributing the finished product in whole or in part, whether on paper or via electronic media, from and against any claims, damages or liability arising from or related to the use of the photographs, including but not limited to any misuse, distortion. blurring, alteration. optical illusion or use in composite form. either intentionally or otherwise. that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution.
I further give permission for my child to participate in all supervised activities except as noted.
