I voluntarily and knowingly authorize any individuals, corporations, and/or organizations with pertinent knowledge to release and/or supply information they have concerning (the child) to South Texas Children's Home Ministries (STCH Ministries). The information to be disclosed and delivered includes but is not limited to the child’s school performance, personal lifestyle, habits, medical records, psychological records, and any other relevant information deemed necessary for the child’s placement at STCH Ministries.
I voluntarily and unconditionally release these individuals, corporations, and/or organizations from all liability resulting from the furnishing of this information. I further promise that I will not bring suit against them for providing information regarding . A photographic, electronic, or faxed copy of this authorization shall be as valid as the original. This authorization also includes authority to copy any and all such records.
This authorization is continuing in nature and is to be given full force and effect to release information on any of the foregoing learned or determined after the date hereof.