Youth Ministry Liability Waiver & Release Form for Church Activities
Please fill out this form and click submit.
Name of Student(s) (separate names with commas please)
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Parent/Guardian Name
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Emergency Contact Name
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Emergency Contact Phone
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Email
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This address will receive a confirmation email
Allergies of Medical Conditions (if any)
Liability Waiver and Release
I, the undersigned parent or legal guardian, understand that participation in activities, events, and programs hosted by South Strand Assembly of God involves inherent risks, including but not limited to physical activity, group interaction, and use of equipment. I voluntarily give permission for the above- named child(ren) to participate in all such activities, events, and programs, and accept that participation is at our own risk. I hereby release, waive, and discharge South Strand Assembly of God, its pastors, staff members, volunteers, and representatives from any and all liability, claims, demands, or causes of action for loss, damage, or injury, including personal injury, illness, or property damage, that may be sustained on the premises or during any church-related activity, whether on-site or off-site. I acknowledge that no medical insurance coverage is provided by South Strand Assembly of God. In the event of an emergency, I authorize church staff or volunteers to obtain necessary medical treatment for my child(ren) and accept responsibility for all associated costs. I grant permission for my child(ren) to be included in photographs or videos taken during activities for promotional or ministry purposes, unless otherwise stated in writing. By selecting yes, I acknowledge that I have read, understand, and agree to this waiver and release, and that I select freely and voluntarily.
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Please select all that apply.
Yes
Please contact Pastor Dylan at 757-848-6248 or Dylan.Kennedy37@gmail.com with any questions.
Submit
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