• Grace Baptist Youth Permission Waiver - 2022-23

  • CHILD'S INFORMATION:

    • 1st Child  

    • 2nd Child  
    • ADDITIONAL CHILD INFORMATION


    • 3rd Child  
    • ADDITIONAL CHILD INFORMATION


    • 4th Child  
    • ADDITIONAL CHILD INFORMATION


    • Parent Info  
    • PARENT/GUARDIAN INFORMATION:

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    • We also give permission for any "Youth Group" picture that includes my/our child(ren) to be used on Grace Baptist Church’s website and facebook page---

    • MEDICAL INFORMATION

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    • Waiver/Release:

      I, the undersigned parent/guardian, do hereby grant permission for my son/daughter, named above, to be accepted for all activities to be held by Grace Baptist Church on or off church premises during the period of September 1, 2022 through August 31, 2023 we (I) do hereby release, forever discharge and agree to hold harmless Grace Baptist Church at 5050 Middlebranch Avenue NE of Canton, Ohio; its pastors, directors, Awana leaders and youth leaders from any and all liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the child participant that occur while said child is participating in the above described activities.  Furthermore, we (I) hereby assume all risk of personal injury, sickness, death, damage and expense as a result of our (my) child(ren)'s participation in recreation and work activities involved therein.

      We (I) are/am the parent(s) or legal guardian(s) of this/these participant(s), and hereby grant permission for him/her/them to participate fully in any trip/event and hereby give permission to the pastors, directors and/or youth leaders involved to take said participant(s) to a doctor or hospital for authorized emergency treatment, including but not in limitation to emergency surgery or medical treatment, and assume the responsibility of all medical bills, if any.  I also understand that every attempt will be made to notify us (me) or the emergency person listed below in such an emergency.  Furthermore, should it be necessary for the participant(s) to return home due to medical reasons, disciplinary action or otherwise, we (I) assume all transportation costs involved.

    • I agree to "self-screen" my child at home for symptoms of illness (fever, cough, etc.) and will not bring them to Youth Group if they have any symptoms .

    • Should be Empty:
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