Parent or Legal Guardian Release Form Parent or Legal Guardian Release Form I, do knowingly and willfully allow,(Required)Name of Team Leaderto take my minor child, into Honduras.(Required) First Last Start Date(Required) MM slash DD slash YYYY Finish Date(Required) MM slash DD slash YYYY Consent(Required) I know that they will be traveling with Ministries of Divine Mercy Inc., MDM Honduras, Operation New Life, and Love Truth Care Ministries during the start and finish dates listed above.(Required)Consent(Required) I hereby release Ministries of Divine Mercy Inc., MDM Honduras, Operation New Life, and Love Truth Care Ministries and their appointed agents from any liability as a result of an accident, sickness or death that the above mentioned minor child may incur while participating in this outreach.(Required)Consent(Required) I authorize the leadership of Ministries of Divine Mercy Inc., MDM Honduras, Operation New Life, and Love Truth Care Ministries to take the above mentioned minor child to a doctor for medical treatment, emergency surgery, and/or hospitalization should the need arise.(Required)Consent(Required) I will assume total responsibility for payment of all bills associated with the above-mentioned minor child’s medical attention.(Required)Consent(Required) I will assume total responsibility for payment of all associated transportation costs should it be necessary for the above mentioned minor child to return to the United States for any reason prior to the established return dates.(Required)Signature of Releasing Parent or Legal Guardian(Required)Date(Required) MM slash DD slash YYYY Releasing Parent or Legal Guardian's Full Name(Required) First Last Relationship to Minor Child(Required)ParentLegal GuardianCase WorkerEmail(Required) Phone(Required)Minor's Full Name(Required) First Middle Last Age(Required)Date of Birth(Required) MM slash DD slash YYYY In the Event of an Emergency Contact:Name(Required) First Last Relationship to Minor Child(Required)Phone(Required)Mobile, Home, or WorkMobileWorkHomeWe will treat your information in accordance with our Terms of Use and Privacy Policy.
