FOL Medical Release Form

Eastern Nazarene College – March 16-19, 2017

Having been made aware of the activities the registrant will be doing, I hereby consent to the registrant’s participation in Festival of Life. I indemnify, defend, and hold harmless Eastern Nazarene College, as well as the District and Eastern Field Nazarene Youth International, for all claims made and liabilities assessed against them as a result of a registrant’s activities. Further, in case of emergency, I understand that every effort will be made to contact parents or guardians of a minor registrant. However, if parents or guardians cannot be reached, or if I, the below signed registrant am 18 years , I hereby give Eastern Nazarene College and the District and Field Nazarene Youth International to act on my behalf in seeking medical treatment in the event that such treatment is deemed necessary or advisable for the registrant’s health, safety, and welfare. I give permission to those administering medical treatment to do so, using the measures deemed necessary. I release Eastern Nazarene College and the District and Field Nazarene Youth International and all medical providers from liability in acting on behalf in this regard and rendering such medical treatment. I assume risk and financial responsibility for any injury resulting from the registrant’s activities.

FOL Medical Release Form

REGISTRATION

EMERGENCY CONTACT