Registration Information

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In case of emergency, I authorize an adult, in whose care the minor has been entrusted for the purpose of participating in Wednesday’s Church School activities, to consent to any x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment and/or hospital care rendered to the minor(s) on the advice of a physician or dentist, whether such diagnosis or treatment occurs at the office of the physician/dentist or at the hospital. Attempts will be made to contact parents/guardians if that need for treatment arises. The undersigned shall be liable for and agrees to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child pursuant to this authorization. The undersigned does also give permission for my child to ride in any vehicle designated by the adult in whose care the minor has been entrusted while attending and participating in activities sponsored by Gloria Dei Lutheran Church. I understand the vehicles used most frequently for after school pick-up will be the church bus and/or van.

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