Students in middle school and high school are provided opportunities for weekly meetings, Sunday church, service projects, and fun events.

Hard Pressed youth group - Wednesday nights AT 6PM

GRADES 6TH TO 12TH

GRACE FELLOWSHIP YOUTH MEDICAL RELEASE

Student's Name

First Name

Last Name

Date of Birth

Parent/Guardian Name

First Name

Last Name

Phone

(###)

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####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Phone

(###)

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Release Information

(Student)_____________________________ has my permission to attend Hard Pressed Youth by Grace Fellowship Evangelical Free Church (hereinafter "the church"). This consent form gives permission to seek whatever medical attention is deemed necessary and releases the church and its staff/leader of event, of any liability against personal losses of named child. This also gives Grace Fellowship permission to take and use photos of your child. I/we the undersigned have legal custody of the student named above, a minor, and have given consent for him/her to attend the event listed above. I/we understand that there are inherent risks involved in any ministry 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.

Parent Signature (Type Name)

GRACE FELLOWSHIP STUDENT MINISTRIES TRANSPORTATION LIABILITY WAIVER:

Student's Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Current Grade

Phone

(###)

###

####

Parent/guardian Name

First Name

Last Name

Parent/Guardian Phone

(###)

###

####

Please the following:

I hereby grant permission for my child to participate in the upcoming church event. I acknowledge that there are inherent risks associated with any activity and I assume full responsibility for those risks. I understand that travel may be involved, and I hereby give permission for my child to travel with the adult leader or leaders of this activity, including transportation by car, bus, train, airplane, or any other means. I understand that it may be necessary for emergency medical treatment to be administered if an injury or illness occurs during activities. I grant permission to an adult leader of this activity, my appointed agent if needed, to provide consent for any medical diagnosis or treatment including x-ray examinations; dental services; surgery and hospital care advised by a licensed physician, surgeon or dentist in the state where these services are rendered. This may include visits at a doctor's office as well as hospitals. I understand that it is incumbent upon me and/or my child to follow all rules as set forth by the church concerning this event. Further, I acknowledge that any misconduct or misbehavior on the part of my child or myself may result in immediate dismissal from the event, at the sole discretion of the church staff. I also agree to release and hold harmless the church and its staff from all liability related to injury or illness that may occur to my child in relation to this event or any activity associated with it. In the event of an emergency, I consent to medical treatment provided by a doctor or hospital of the church's choice. I have read and understand all regulations associated with this event, as well as the above statements.

Date

MM

DD

YYYY

Students in middle school and high school are provided opportunities for weekly meetings, Sunday church, service projects, and fun events.

Hard Pressed youth group - Wednesday nights AT 6PM

GRADES 6TH TO 12TH

GRACE FELLOWSHIP YOUTH MEDICAL RELEASE

GRACE FELLOWSHIP STUDENT MINISTRIES TRANSPORTATION LIABILITY WAIVER:

For more information contact youth pastor Chad Vanderburgh at [email protected]