FedYouth 2026-27 Permission Slip

FedYouth 2026-27 Permission Slip

Complete this form to provide parental permission for your child to participate in FedYouth activities during the 2026-27 ministry year.
Student Name(s)
Parent/Guardian Name

First NameLast Name
Parent/Guardian Email
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Medical Information
Allergies
Liability Agreement and Parental Consent
I consent for my student to participate in the FedYouth group program at the Federated Church during the 2026-2027 school year. I understand that FedYouth ministry will carefully plan and surpervise every activity, yet accidents and injuries still may occur. By signing this form I agree to and assume all risk and hazards during FedYouth events, which may include weekend retreat or day trips that could involve transporting your student to/from an event. I also agree not to hold the Federated Church or the volunteers and staff of FedYouth ministry repsonsible in the event of an injury to my student. In the event that staff or volunteers are unable to reach me, I give permission for treatment if deemed necessary. Insurance is considered to be the personal responsibility of the program participant.
Insurance Company
Primary Doctor
Insurance number
Group Number
Parent/Guardian Permission
I understand that FedYouth ministry events are often photographed/recorded for publication and public relations and I grant permission to Federated Church and FedYouth volunteers to use photos/videos of my child for these purposes.
Parent/Guardian e-sign
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

FedYouth 2026-27 Permission Slip

Liability Agreement and Parental Consent