Real Youth Co - Permission + Contact Slip • Parkway Church

LET'S CONNECT!

WE WANT YOUR YOUTH TO BE INCLUDED IN WHAT IS GOING ON AND FOR THEM TO BE SAFE WITH US HERE AT PARKWAY.

PLEASE FILL OUT THE SHORT QUESTIONNAIRE BELOW TO MAKE SURE YOU GET ALL OF THE NECESSARY UPDATES!

Guardian's First Name *

Last Name *

Email Address *

Mobile phone Number *

Address *

How many youth students are you registering (those under your care) *

Youth's Full Name: *

Health Card #: *

Tip: If something happens (which we pray doesn't) and you happen to be away from your phone, it is vital that we have your student's health card information. Only Pastor Zoe has access to this sensitive information in case of emergencies.

Youth's Full Name

Health Card #:

Youth's Full Name:

Health Card #

I prefer to receive youth group updates through: *

Text

A post on a social media page

Any of the above

In case of emergency, please contact: *

WAIVER FORM AND MEDIA RELEASE:

While every precaution is taken for the safety and good health, some sports and activities carry with them the inherent risk of personal injury beyond the risks associated with many of the recreational activities at Parkway Pentecostal Church. I/we understand and accept these risks and agree that by allowing my child to participate in those activities, he/she may be taking part in a recreational activity that presents the potential for personal injury. I/we further understand that any photos/videos taken for promotional needs of the marketing of the programs may include the presence of my child.Any/all of these images will be used solely for Facebook/website marketing.

I/we the parents or guardians named below, authorize the Pastor or one of Parkway Pentecostal Church ministry personnel to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above.

I/We, named below, undertake and agree to indemnify and hold blameless Parkway Pentecostal Church and its personnel, it's Pastors and Board from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Parkway Pentecostal Church and as well as of any medical treatment authorized by the supervising individuals representing Parkway Pentecostal Church. This consent and authorization is effective only when participating in or traveling to/from events of Parkway Pentecostal Church.

In the case of possession of dangerous items or non-compliant behavior, at the discretion of the Youth Pastor, parents/guardians will be contacted and required to pick up their child immediately. Students are required to honor the boys/girls cabin rules. Any non-compliance at the discretion of the Youth Pastor, parents/guardians will be contacted and required to pick up their child immediately.

I understand the terms and give permission for my child to participate.