2026 Vyouth Beach Nights Waiver & Release

Throughout this Agreement, the individual signing as the parent or legal guardian shall be referred to as “Parent/Guardian,” and the minor child participating under this Agreement shall be referred to as “Student.” Students who are 18 years of age or older may sign this Agreement on their own behalf.

If the student attending the Vintage Church LA event requires medical attention or medicine for pre-existing injuries or illnesses, written instructions must be provided to the Youth Leadership Team by the parent / guardian no later than one week in advance of the start of the event.  

In the case of an unexpected illness or injury which occurs while the student is attending a Vintage Church LA event, the parent or guardian’s health insurance will be billed for any necessary emergency medical treatment. Health insurance information must be provided by the parent / guardian to the Youth Leadership Team in advance, and any updates to your insurance policy must be provided in writing.

Authorization of Consent to Treatment:

(I) (We), the undersigned parent / guardian of Student, do hereby authorize Vintage Church LA youth ministry leaders, as agent(s) for the undersigned Student, to consent to any dental care, x-ray examination, anesthetic, medical or surgical diagnosis or treatment, and hospital care which is deemed advisable by, and is rendered under the general or specific supervision of any physician and/or surgeon licensed under the provision of the Medical Practice Act, whether such diagnosis or treatment is rendered at the office of said physician or at a hospital, or anywhere else where emergency treatment may need to be administered.

It is understood that this authorization is given in advance of any specific diagnosis, treatment, or hospital care being required, and will be considered as advance authorization for any and all events, projects, ministries, small groups, or trips initiated and administered by Vintage Church LA at which the student named in this agreement participates.

It is further understood that, if needed, the authorization to approve or consent to any necessary emergency treatment recommended by an emergency medical professional or hospital staff will be made at the sole discretion of the Youth Leadership Team if such an emergency occurs during the course of a Vintage Church LA event.

The above authorization is given pursuant to the provisions of Section 25.8 and 34.6 of the Civil Code of California and shall remain effective through the above-named student’s graduation from high school, unless revoked by the parent / guardian in writing to the Youth Leadership Team.

Release of Vintage Church LA
Parent/Guardian, or student (if over the age of 18) shall indemnify, hold free and harmless, assume liability for, and defend Vintage Church LA, its agents, servants, employees, volunteers, officers, and directors from any and all costs and expenses including but not limited to, medical costs, attorney’s fees, reasonable investigative and discovery costs, court costs, and all other sums which Vintage Church LA assertion of liability, or any claim or action founded thereon, arising or alleged to have arisen out of Student’s participation in a Vintage Church LA event, or use of real or personal property belonging to Vintage Church LA, as agents, servants, employees, volunteers, officers, and directors, or by action or omission by Student. 

Vintage Church LA reserves the right to use any audio, video, and/or photography of guests and/or campers participating in Vintage Church LA facilitated events, unless you have indicated otherwise by opting out below.

IT IS ALSO ACKNOWLEDGED THAT IF ANY STUDENT HAS TO RETURN HOME EARLY FOR DISCIPLINARY MEASURES DUE TO CONDUCT VIOLATIONS, IT WILL BE AT THE SOLE EXPENSE OF THE PARENT / GUARDIAN / ADULT STUDENT.

By signing this document, I acknowledge that I have had sufficient opportunity to read this entire document. I have read and understood it and agree to be bound by its terms.