KNOLLWOOD BAPTIST CHURCH

PERMISSION FORM & MEDICAL RELEASE


For your information, we expect each student to conform to these rules of conduct:
  • No possession or use of alcohol, drugs or tobacco
  • No students can drive
  • No fighting, weapons, fireworks, lighters or explosiv
  • No offensive or immodest clothing
  • No boys in girls' sleeping quarters and no girls in boys' sleeping quarters
  • Participation witht eh group is expected
  • Respect property
  • Respect one another, staff and adult leaders
  • Respect and comply with event schedules
Students who fail to comply with these expectations may be sent home a their parents' expense. I, the student, have
read the rules of conduct and permission to participate in youth group activities. I agree to abide by the stated personal limitations and code of conduct.

Student Name      Parent/Custodian Name 

Activities may include, but are not limited to: cookouts, boating, water skiing, swimming, basketball, rollerskating, rollerblading, games in the park, soccer, broomball, ice skating, volleyball, softball, baseball, camping, downhill skiing, snowboarding, hiking, biking, concerts, Bible studies, golfing, miniature golf, hayrides, etc.  Note: If you desire to limit your child's participation in any event, please submit yourwishes in writing to the Minister of Youth and Young Adults prior to that event.

Student Name   has my/our permission to attend all youth activities sponsored by Knollwood Baptist Church (hereinafter the "Church") from January 1, 2010  to  December 31, 2011.

This consent form gives permission to seek whatever medical attention is deemed necessary, and releases the Church and its staff of any liability against personal losses of named child.

I/We the undersigned have legal custody of the student named above, a minor, and have given our consent for him/her to attend events being organized by the Church. I/We understand that there are inherent risks involved in any ministry or athletic event, and I/we hereby release the Church, its pastors, employees, agents, and volunteer workers from any and all liability for any injury, loss, or damage to person or property that may occur during the course of my/our child's involvement. In the event that he/she is injured and requires the attention of a doctor, I/we consent to any reasonable medical treatment deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by the Church, I/we agree to hold such person free and harmless of any claims, demands, or suits from damages arising form the giving of such consent. I /We also acknowledge that we will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance provider. Further, I/we affirm that the health insurance information provided above is accurate at this date and will, to the best of my/our knowledge, still be in force for the student named above. I/We also agree to bring my/our child home at our own expense should thye become ill or if deemed necessary by the student ministries stafff member.

By completing this form and typing your name in the space provided below, the guardian to the above named student, you  have chosen to electronically provide permission for your child.

Parent/Legal Guardian Full Name                      Date Signed 

Address (Street No., Street Name, City, Zip

Phone Number

Allergies

Medications