Hillsdale Free Methodist Youth Group 2025-2026 Consent Form
The following consent form is a general agreement that you are on board with our mission and strategy. Instead of reaching out to you every time we do a physical activity or travel off campus, this is a generic form that states that we have your approval to do so for the 2025-2026 school year (and summer in between school years). This way, if your student shows up for a youth group or event, we already have the information on hand and know that he or she is good to go.
Student Information
Student Name
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First Name
Last Name
Gender
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Male
Female
Date of Birth
*
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Month
-
Day
Year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please list any phone numbers or email addresses in which you want to receive news and updates (not usually more than 2 per month). You can always unsubscribe at any time.
Medical Information
Does your son/daughter/ward have any medical condition or allergy of which the leaders accompanying the group need to be aware?
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Yes
No
If you answered yes to the previous question, please list them here:
Please list your Medical Insurance Provider and Policy Number:
*
Emergency Contacts
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Alternate Emergency Contact
*
First Name
Last Name
Alternate Contact Phone Number
*
Please enter a valid phone number.
Consent & Waiver
It is widely recognized that attendance at youth group or any church group activities, including participation in excursions, games, sports, conferences, or events, and including the use of transport arranged by the church, may entail risks for to the student. Such risks are part and parcel of life and learning.Acknowledging the foregoing, I, parent and/or legal guardian of the under-mentioned, over whom I have custody and control, hereby consent to my son/daughter/ward, participating in the various activities of the Hillsdale Free Methodist Church, (including sports activities, games, small group activities, camps and educational and recreational activities and outings) arranged, organized or offered by the Hillsdale Free Methodist Church and its volunteers, and, where relevant, to his/her being transported to and from the said activities by means of transport made available by the church for that purpose. The entirety of this waiver shall be good through the end of the 2025-2026 School year, which includes the summer of 2026.
I further agree that such participation or use shall be at the risk of the student and his/her parent/guardian. Insofar as every reasonable and practicable precaution is taken for the safety and welfare of my son/daughter/ward and for the care of his/her possessions, I hold blameless all other persons, Hillsdale Free Methodist Church, and all organizations associated with the activity, should any prejudice, loss, damage, illness or injury occur to my son/daughter/ward during the above activities. This includes a waiver against my claiming for recovery of costs resulting from theft, damage, loss and/or medical conditions or hospitalization, unless such loss is caused by the negligence, willfulness or deliberate act of the Church or one or more of its employees or volunteers.
I furthermore appoint the church staff or approved volunteer accompanying the tour or group, or supervising the activity, to act in loco parentis in respect of my son/daughter/ward should the need therefore arise, and where it is deemed by them to be necessary to do so, to take such steps as the church deems reasonable in the event of the applicant becoming ill, being injured, or for any reason requiring medical attention.
By signing this, I agree to the terms of the consent form
Today's Date
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Month
-
Day
Year
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Signature
*
Submit
Submit
Should be Empty: