• NLC KIDS 2023 Parental Consent, Certification and Medical Authorization Form

    Parents and legal guardians of minor children are asked to complete this form. The information requested is designed to assist the church in providing for the safety of minors during church-sponsored activities.
  • ONE FORM PER STUDENT

  •  / /
    Pick a Date
  •  -
  •  -
  •  -
  •  -
  • Consent and Certification

    I,the undersigned, being the parent or legal guardian of the student named above,do hereby consent to the participation of my child in all of the regularly-scheduled activities of the youth or children ministries of New Life Church. This may include field trips, camp outs, swimming, boating, hiking,sporting events, and any other activities customarily associated with a church youth group or kids group. Further, I certify that my child is physically fit and adequately trained to participate in such events, including swimming,(except as noted below).
  • Medical Questionnaire

  • Medical Treatment Authorization

    I understand that I will be notified in the case of a medical emergency involving my child.  However, in the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event my child is injured or becomes ill.  I authorize the New Life Church Staff to make emergency medical care decisions on behalf of my child, if required by law or a health care provider I understand that the church will not be responsible for medical expenses incurred solely on the basis of this authorization. I agree to notify the church in the event of any health changes which would restrict my child’s participation in any normal youth or children’s activities.  I also understand that the adult supervisors reserve the right to restrict my child from any activity that they do not feel is within the physical capabilities of my child.
  •  - -
    Pick a Date
  • Clear
  • Should be Empty:
Jotform Logo
Now create your own Jotform - It's free!Create your own Jotform