Hold Harmless Statement:

Consent to Participate and Transportation
I hereby give permission for my child to attend and participate in activities sponsored by Milestone Church. I hereby authorize Milestone Church to transport my child to and from church and/or any other church related and sponsored activities and event. If transportation is provided by Milestone Church to a Milestone Church campus activity and/or event, my child is required to take the Milestone Church provided transportation back to the original location unless released to a parent or guardian. I authorize Milestone Church to include my child in routinely supervised water activities.

Consent to Medical Treatment
I hereby authorize Milestone Church to take my child to the nearest physician or medical facility for medical treatment in the event of an emergency in which neither parent can be reached after reasonable attempts to do so. I hereby authorize Milestone Church to consent to an x-ray examination, anesthetic, medical, surgical, or dental treatment, and hospital care to be rendered to my child under the general or special supervision and on the advice of any physician or dentist representing to be licensed on the medical staff of a hospital or medical care facility chosen by Milestone Church. I do hereby authorize any physician, dentist, hospital or medical treatment center to treat my child in the case of an emergency in which neither parent can be reached to give specific directions as to a named physician or dentist. The undersigned adult shall be liable and agrees to pay all costs and expenses incurred in connection with such medical and/or dental services rendered to the child listed below. Should it be necessary for my child to return home due to medical reasons or otherwise, the undersigned shall assume and be responsible for the payment of all transportation costs. I hereby do authorize Milestone Church to dispense to my child any over-the-counter medications (according to proper dosage instructions) when reasonably deemed necessary.

Hold Harmless and Photo + Video Release
I hereby release, forever discharge and agree to defend and hold harmless Milestone Church from any and all liability, claims or demands for personal injury, sickness or death, as well as property damages and expenses, of any nature whatsoever which may be incurred by the undersigned adult and the child/participant that occur while said child is participating in any trip or activity with Milestone Church. I (and on behalf of my child) hereby assume all risk of personal injury, sickness, death, damage and expenses as a result of participation in recreation and work activities involved therein.Further authorization and permission is hereby given to Milestone Church to furnish any necessary transportation, food, and lodging for my child. The undersigned further hereby agrees to hold harmless and indemnify Milestone Church from and against any claim or loss incurred by Milestone Church as the result of the negligent willful or intentional acts of my child, including any expense incurred attendant thereto. I grant Milestone Church the absolute and irrevocable right and unrestricted permission concerning photos and/or videos taken of my child at any Milestone Church event to be used in any and all media, including the internet, for the purpose of illustration, promotion, art, and/or production.

Emotional Disclosure Policy
I hereby acknowledge that Milestone Church abides by federal and state laws and guidelines for the safety of students in circumstances when and where Milestone Church maintains a responsibility to ensure their well-being.
During the course of overnight camps and/or day camps students are encouraged to be involved in small group discussions. In a situation where past or present “hurts” falls within abuse, harm, or neglect there are steps that our leaders take in order to protect your student. Procedures for reporting and addressing the “3 Harms”: harming self, harming others, being harmed:

The government requires that we report any alleged abuse of minors.

We also report any potential harm of a minor to a safe parent/guardian. Reporting to a safe parent/guardian can be done by the minor and staff member will follow-up, by the staff member, or together by the staff member and the minor, all in accordance to our “3 tells”; you tell, I tell, or we tell.

If a minor is in immediate danger then a call is made to the police department and a wellness check is requested.

If a minor is physically safe for the moment but has not been in the past or might not be in the future, we tell the minor that we need to inform a safe parent/guardian of their choice and when warranted by state reporting laws, and we also call DFPS to report our knowledge of recent or potentially ongoing abuse. We also call the police if there has been a crime. Harms in this category include sexual abuse, rape, neglect, physical abuse, exposure to explicit material to a minor, self-injury, risky drugs.

We report any drug or sexual activity between minors to a safe parent/guardian.

An Incident/Accident Report is to be filed out for any of the above situations and turned into human resources to keep on file.

The medical consent and liability waiver provisions hereof shall remain in full force and in effect until written notice of revocation or withdrawal is received by Milestone Church at its office at 201 Mount Gilead Rd, Keller, Texas. I acknowledge and agree that it is my responsibility to notify Milestone Church of any changes in medical condition, guardianship, address or cell phone, in writing to the address listed above.

The following options are available for this registration:

Keller Campus | High School Camp

How many students will you be registering?