FLC Youth Ministry Offsite Event Permission Form

Friday Knights & ACTS (Gr.7-12)
Date: January 23, 2026
Drop-off Time: 7:00pm
Pick-up Time: 9:30pm

Cost: $24/youth (cash or e-transfer to donations@fraserlands.ca - "YouthRC FullName)

Location: The Hive Surrey (11125 124 St #101-B, Surrey, BC V3V 4V2)

Description: We are going to a bouldering gym to practice our rock climbing skills! Shoe rentals are included in the registration cost, and there will be instructions provided by the staff at the venue. Some of our counsellors are also experienced climbers who are attending to provide supervision.

Transportation: We are encouraging parents to either drop off your kids directly at the venue, or arrange carpooling with other parents who may be driving to the event. Some of our counsellors may be able to provide rides as well, but it is dependent on if they are able to operate within our Safety & Risk Management policies.

Grade & Counsellor Information:

Grade 7 Girls:
Constance Fung (constancefung321@gmail.com / 778-980-6113)

Grade 7-8 Boys:
Carver Lan (carverlan@outlook.com / 604-356-2982)

Grade 8 Girls:
Chelsea Bigsot (chelseabigsot@gmail.com / 250-808-3178)
Christy Sun (christy8488@gmail.com / 604-360-8488)

Grade 9-10 Girls:
Angela Chan (angelahu@live.ca / 778-683-6017)
Olivia Lo (olivialo.95@hotmail.com / 778-384-4393)

Grade 9-10 Boys:
Seth Mendoza (sethmendoz@gmail.com / 778-919-3246)

Grade 11 Girls:
Justine So (justinesew@gmail.com / 778-688-6995)
Alison Wong (alisonchan16@gmail.com / 604-910-3355)

Grade 11-12 Boys:
Chris Li (chris.zhk.li@gmail.com / 778-998-0388)
Ryan Wong (rtwong11@gmail.com / 604-603-6588)

Grade 12 Girls:
Melanie Jang (melaniejangg@gmail.com / 604-655-7828)

Drop-Off / Pick-Up (Use the "Other" field if you have arranged alternate transportation plans)

Other

Child's Name

First NameLast Name

Child's Gender

Child's Grade

Please select FK (Gr.7-9) or ACTS (Gr.10-12) to help us maintain our S&RM policies.

Medical Number (PHN)

Allergies

Other

Parent/Guardian Name

First NameLast Name

Parent/Guardian Email

example@example.com

Parent/Guardian Primary Phone

Area CodePhone Number

Emergency Contact

First NameLast Name

Emergency Contact Phone

Area CodePhone Number

Child's Relationship to Emergency Contact

I hereby give my permission for my child to attend the off-site event stated above. I understand that this event will be supervised by church workers and/or volunteers who will take reasonable precautions and care of my child. They will also be responsible for transportation unless other arrangements have been made in advance. In the event that my child may require immediate medical attention, I give my permission for the supervisors responsible to transport my child to a hospital or seek emergency medical help. I will be contacted immediately if any situation arises that warrants my attention. Volunteers and workers of Fraser Lands Church will not be held liable if injury or accident to my child occurs during the course of the event.

Signature of Parent/Guardian

FRASER LANDS CHURCH PERMISSION FORM FOR CHURCH-SPONSORED OFF-SITE EVENTS PARENTAL CONSENT & MEDICAL RELEASE