The Medical Release form below must be printed,completed, notarized; then mailed to:
Rev. Charles A. Bledsoe,
9059 Kettering Ave
White Lake, MI 48386 USA
List two (2) persons, on our team, who can authorize emergency medical treatment if needed. Rev. Charles A. Bledsoe is listed as an authorized person. If emergency treatment is necessary and the situation permits we intend to contact your Emergency Contact before treatment is given. Do not list yourself as an authorized person. If you do not know a second person on our team, leave this space blank.