Parental/guardian General Release Of Liability For Minors printable pdf download

Parental/guardian General Release Of Liability For Minors

Parental/Guardian General Release of Liability for Minors

Carlisle Evangelical Free Church

YOUTH’S INFORMATION

Name ___________________________________ Grade ______ DOB ____/____/____ Male/Female

Primary Address: _____________________________________________________________________

Secondary Address: __________________________________________________________________

Youth’s Email ________________________________________________________________________

Youth’s Home Phone ________________________ Youth’s Cell Phone _______________________

PARENT/ GUARDIAN INFORMATION

Name(s) _____________________________________________________________________________

Email(s) _____________________________________________________________________________

List all phone numbers where the parent/guardian can be reached (type: i.e. home, cell)

Name_____________________________ #_______________________ Type? _________

EMERGENCY CONTACT

Name________________________________ #_______________________ Relation? _____________

PARENTAL CONSENT

The undersigned does hereby give permission for my child ________________________________

(child’s name) (“Participant”), to attend and participate in a CEFC Short Term Missions to

_____________________ (location) during the period of __________________________ (inclusive

dates).

LIABILITY RELEASE: In consideration of CEFC allowing the Participant to participate in

children/youth ministry (Sunday worship, Sunday meeting, Activities, Events, Retreats, Short

Term Mission Trips) and childcare, I, the undersigned, do hereby release, forever discharge and

agree to hold harmless CEFC, its pastors, directors, employees, volunteers and teachers

Parental/guardian General Release Of Liability For Minors