Senior Trip LSM Senior Trip 2024 Student First Name Student Last Name Parent Name Parent Phone Number Parent Email I agree to the following Statement(Required) I agree to the Medical Release Form listed below: I understand that in the event of an emergency due to sickness or accident while involved with the activity of Lamar Baptist Church, Arlington, Texas, every attempt will be made to contact immediately the persons listed on this form. In the event I cannot be reached, I hereby give my permission to the physician selected by the person in charge to secure any necessary medical and/or surgical treatment for my child. I also understand my signature below indicates that this form is valid for any and all activities my child is involved in with Lamar Baptist Church during the year 2024 and that if any of the information I have provided changes I will contact the church with this information. I understand that my insurance coverage for my child will be used as primary coverage in the event medical intervention is needed and that I will be responsible for all remaining copays and/or percentages not covered by my insurance. I understand all reasonable safety precautions will be taken at all times by Lamar Baptist Church and its agents during the events and activities. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold Lamar Baptist Church, its pastors, leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by my child. Δ