• Youth Event Authorization Form

    Please complete one form for each participant.

  • Event Information

  • Event Name: Firebrand 2026
    Date(s): July 10-11, 2026
    Location: Garrett County Fair Ground Ag Hall Building
    270 Mosser Rd
    McHenry, MD 21541
       

    Lodging:

    		 Microtel Inn & Suites by Wyndham Hazelton/Bruceton Mills
    886 Casteel Road
    Hazelton, WV, 26525
    (304) 379-7900
       
    Participant Cost: Event admission and lodging are free. Participants will be responsible for their own meals.

  • Participant Information

    Please provide your child's information.
  • Date of Birth*
     - -

  • Parent/Guardian Information

    Please provide your contact information.
  • Format: (000) 000-0000.

  • Emergency Contact

    Please provide someone other than you who can be contacted in the event of an emergency if you are unavailable?
  • Format: (000) 000-0000.

  • Medical Information

    Please disclose any relevant medical information.
  • Is your child allergic to anything we should know about?*
  • Does your child have any medical conditions that we should be aware of?*
  • Does your child have any dietary restrictions?*
  • Will your child be bringing any prescription medications?*
  • Is your child permitted to self-administer prescribed medication (such as an inhaler or EpiPen)?*
  • Select the OTC medications that may be administered to your child if needed.*

  • Parent Consent & Authorizations

    Please review the following permissions and acknowledgements.
  • Pool Permission: If the hotel has a pool, do you give permission for your child to use the pool?*
  • Photo/Video Release: I grant permission for my child to be photographed or videotaped during the event and for images to be used in promotional materials.*

  • By checking the box below, I certify that I have read, understand, and agree to the following:

    • I give permission for my child to attend and participate in the event described in the Event Information section above, including overnight lodging if applicable.
    • I give permission for my child to be transported by church leaders or designated drivers as necessary for this event if applicable.
    • I understand that my child is expected to follow the instructions of church leaders, respect other participants, and behave appropriately throughout the event. If my child's behavior becomes disruptive, dangerous, or violates event expectations, I understand I may be contacted and required to pick up my child at my own expense.
    • I authorize church leaders and any licensed medical personnel serving with the group, when available, to obtain emergency medical treatment for my child if neither I nor the the Emergency Contact can be reached.
    • I understand that reasonable precautions will be taken to ensure my child's safety; however, participation in this event involves the normal risks associated with travel, lodging, recreation, and group activities. I acknowledge these risks and release Restoration Church International, its staff, and volunteers from liability except in cases of gross negligence or willful misconduct.
  • Date Signed*
     - -
  • Should be Empty: