Cornerstone Bible Church
317-569-5100 ronda@discovercbc.org
16508937 10211042379916057 5708845935659091835 n

CSM Summer Retreat

July 16th - July 20th, 2018

$235

By registering with this form you are authorizing Cornerstone Bible Church in case of emergency with your child/children to:

  1. Determine whether an emergency exists.
  2. In an emergency, call 911 for assistance or take your child to an outpatient clinic or hospital for medical, dental, or surgical examination.

If we arrive before you, this consent authorizes us to approve X-rays, emergency medication, or laboratory procedures which, in the opinion of the physician in charge, are reasonably necessary or advisable. If surgical procedures are need-ed (e.g. setting a bone or other procedures requiring local or general anesthesia) we will inform you of the emergency and the procedures being followed.

Cornerstone Bible Church, Church staff will not be responsible for medical expenses incurred; these expenses will be the responsibility of the parent or legal guardian. Your registration acknowledges that you have read this form in its entirety and assume all liability for your child.