Fifth Grade and below Medical Release Form 2021 to 2022 - Maywood Evangelical Free Church


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Emergency Information


In Case of Emergency, when parents are not available, please contact:

Medical Insurance Information


Medical Information


Although it is our sincere desire to provide a safe environment for our children, we also recognize that accidents can, and sometimes do, happen. If such a situation should occur, our first response will be to contact you, the parent, unless it is a life-threatening injury where it would be wise to seek immediate medical attention. The purpose of this form is to allow us to obtain first aid care for your child if we are unable to contact you.

Since trips/activities are arranged for the benefit of those participating, it is understood that Maywood Evangelical Free Church and its employees and adult supervisors will execute caution, good judgment, and care but cannot be responsible in case of accident, injury, and loss or damage of property in connection with any trip/activity, and the undersigned will save them harmless from all such claims.

The undersigned further agrees to admonish the child participating in the program to exercise care, to be well-behaved and in all things obedient to and under the direction and control of those adults in charge.