Primary Contact Information
Complete this section ONLY if you are the primary contact for the youth, but are not the parent (grandparent, guardian, caretaker, etc.). If you are not the official guardian, also complete the Parent Information.
Emergency Contact Information
I hereby give permission for this youth to participate in events and activities hosted by Living Word Christian Church and receive oversight from the authorized staff in charge, whose care the youth has been entrusted into while attending and participating in these events and activities. (Note that all staff must be a member of Living Word Christian Church and must comply with a background check and any/all restrictions thereof.)
I hereby give permission to Living Word Christian Church for this youth to be offered snacks by authorized staff while in attendance.
I hereby give permission to Living Word Christian Church to record pictures or videos of this youth while in attendance. I give permission to Living Word Christian Church to use these pictures or videos in church publications including, but not limited to, print publications, slideshows, church website, church social networks, etc. knowing that the youth's identity is kept anonymous.
I hereby give permission to Living Word Christian Church for this youth to ride in a vehicle designated by authorized staff, for the purpose of transportation to and from events and activities hosted by Living Word Christian Church. (Note that all drivers must be at least 21 years of age and produce a valid driver's license and proof of insurance.). This permission does not include personal transportation, only that as part of the activity.
Medical Information & Permission
Please note all applicable allergies, medical conditions, mental conditions, health history, or medication information that would be necessary in an emergency:
Release From Liability
I hereby hold harmless Living Word Christian Church, aka Word of Life Ministries, Inc., and any of its employees, staff, members, and/or volunteers of any liability incurred at or as a result of attending events and activities hosted by Living Word Christian Church.