I (we) acknowledge that my child's participation in Grace UMC Student Ministry programs is voluntary & may require involvement in activities that require travelling or physical exertion. Such activities may include, & are not limited to, outings, athletic games, local excursions, & meetings. I (we) acknowledge that my child's participation in any Grace UMC Student Ministry activity presents risk that my child may suffer property damage, bodily injury, or death. Therefore, in consideration of my child's being allowed to participate in the Grace UMC student ministry activities, I (we) agree to the following:
Grace UMC is not responsible for the loss or theft of personal belongings.
Misconduct may result in transportation home from an activity at parents’ expense. A student dismissed for a disciplinary reason will not receive a refund of the activity fee.
I (we) understand and authorize that my child’s image may be photographed or filmed and used in Grace UMC video presentations, printed publications, & website.
I (we) hereby take the following action for my child, myself, my executors, administrators, heir, next of kin, successors
and assigns: A) I waive, release, and discharge from any and all claims or liabilities for death or personal injury damages of any kind, which arise out of or relate to my child’s participation in Grace UMC’s Youth activities, the following person, or entities: Grace UMC Church, its pastoral & program staff members, employees, volunteers, representatives, subcontractors and agents of any of the above: B) I agree not to sue any of the persons or entities mentioned above for any of the claims or liabilities that I have waived, released or discharged herein except in the case of gross negligence on the part of the aforementioned parties and: c) I indemnify and hold harmless
the person or entities mentioned above from any claims made or liabilities assessed against them as a result of my child’s actions. I hereby assume the risks of my child participating in all Grace UMC Youth Ministries.
The parent and natural guardian or legal guardian of the student named above hereby executes this document for and on behalf of the minor named herein. I agree to indemnify and hold harmless the person or entities mentioned above for any claims or liabilities assessed against them as a result of any insufficiency of my legal capacity or authority to act for and on behalf of the minor in
the execution of the Waiver and Release.
I hereby authorize any licensed physician, emergency medical technician, hospital, or other medical or health care facility to treat the minor named herein for the purpose of attempting to treat or relieve any injury received by said minor. I authorize any such Medical Provider to perform all procedures deemed medically advisable in attempting to
treat or relieve any such injuries. I consent to the administration of anesthesia as deemed advisable. I realize and appreciate that there is a possibility of complications and unforeseen consequences in any medical treatment, and I assume any such risk for and on behalf of myself and said minor. I understand that attempts will be made to contact me in the most expeditious way possible. Permission is also granted to Grace UMC representative to provide the
needed emergency treatment to the student prior to his admission to a medical facility.
I give my permission to the staff to administer Tylenol/Acetaminophen, Ibuprofen, Benadryl/Diphenhydramine or over the counter antacids as needed.
Rules of Conduct:
Respect adult team members & fellow students.
Respect property & facilities.
Respect & comply with event schedules.
Participation with the group is expected.
No fighting, weapons, fireworks, or explosives. No alcohol, recreational drugs, abused substances, nicotine products, or lighters. No offensive or inappropriate clothing.
Failure to comply with these expectations could result in your child being sent home at your expense.
My child has permission to attend all church sponsored youth activities as listed in calendars and/or Grace UMC Newsletter, including but not limited to cookouts, boating, water-skiing, swimming, basketball, roller-skating, rollerblading, games in the park, soccer, paintball, broomball, ice-skating, volleyball, softball, baseball,
camping, downhill skiing, snowboarding, hiking, biking, concerts, Bible studies, golfing, miniature golf, hayrides.
Note: If it is your desire to limit your child’s participation in any particular event, please submit your wishes in writing to Grace UMC prior to that event.
