I give permission for my child to participate in Vacation Bible
School (VBS) at Rockland Chinese Alliance Church, located at 31 Main Street, Tappan, NY. I consent to his/her participation in the activities
planned for this event and certify that he/she is physically able to engage in the event. I hereby grant the leader(s) in charge of the VBS the right to make emergency medical decisions for my child in the event I cannot be reached. I understand I/we release and forever discharge Rockland Chinese Alliance Church, its staff and adult chaperones from any and/or all claims, demands, actions, or causes of action, past, present or future arising out of any damage or injury to my child whose name appears in this form, while participating in this event.