Permission to provide Necessary Treatment or Emergency Care: I hereby give my permission to the Mt Zion Lutheran Church staff to order x-rays, routine tests, treatment, to release any records necessary for insurance purposes, and to provide or arrange necessary related transportation for me/my child. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by Mt. Zion to secure and administer treatment, including hospitalization, for the person named above.

Permission to participate in the Program: I give permission for my child to attend and participate in the Mt Zion Lutheran Church Sunday School and its related activities. I acknowledge that photographs may be taken of my child, and I give my permission to include them in promotional materials for Mt Zion Lutheran Church.