Functions and Activities
It is my understanding that participating in the programs and recreational and other activities of CANYON CREEK CHURCH is a privilege. Prior to my child/youth’s participation in such activities, I acknowledge that there are certain risks associated with the activities including, by way of example, physical injury due to activity related accidents, physical injury due to transportation related accidents, illness, or even death. In addition, I acknowledge that there may be other risks inherent in these activities of which I may not be presently aware.
Release of Liability
By signing this Permission/Waiver Form, I expressly warrant that the child/youth named above is capable of withstanding the physical demands of the activities discussed above. I further release and agree to hold harmless, defend and indemnify CANYON CREEK CHURCH and its directors, officers, employees, leaders and agents from and against any and all claims for personal injury (including loss of life) and all other losses or damages, except those caused entirely by the gross negligence or intentional conduct of Canyon Creek arising from my or my child’s participation in its activities and programs.
First Aid and Emergency Medical Treatment
I recognize that there may be occasions where the child named above may be in need of first aid or medical treatment as a result of an accident, illness, or other health condition or injury. I do hereby give permission for agents of CANYON CREEK CHURCH to seek and secure any medical attention or treatment for the child named above, including hospitalization, if in the agent’s opinion such need arises. In doing so, I agree to pay all fees and costs arising from this action to obtain medical treatment. I give permission for attending physicians(s) and other medical personnel to administer any needed medical treatment, including surgery and, again, I agree to pay for the medical treatment.
Special Events and Field Trips
I understand that the child/youth named above will be participating in various activities from September 1, 2018 through August 31, 2019. I understand that during this period my child/youth may take part in activities such as: Winter Camp, Youth Convention, Missions Trips and other activities consistent with the purposes of the church. I also understand that I may be asked to sign Special Permission Slips in addition to this form.
On occasion, CANYON CREEK CHURCH takes photographs or makes an audio or video tape recording of children and/or adults involved in church activities. Such photographs or video records may be used by staff and participants to remember the activities or participants. In addition, such photographs and audio/visual recordings may be used in CANYON CREEK CHURCH publications or advertising materials to let others know about our ministry. In addition, local news organizations may hear of our activities or events, and our church may invite or allow them to photograph or record our events for news reporting on special interest features. I consent to the use of any such audio or visual record of the child named above to be used, distributed, or displayed as agents of the church see fit. This consent includes but is not limited to: photographs, videotape, and audio recordings. Furthermore, I give permission for the child to be interviewed by the news media, or for such photographs and other audio or visual records to be used by the news media.
MEDICAL HISTORY, SPECIAL MEDICAL NEEDS OR CONCERNS, MEDICATIONS, ALLERGIES, DIETARY NEEDS, CONDITIONS AND/OR OTHER INFORMATION THAT LEADERS SHOULD KNOW ABOUT YOUR CHILD/YOUTH SHOULD BE LISTED ON BACK.
I represent that I am the parent/guardian of the above child, who is under 18 years of age. I have read the above Permission/Waiver Form and am fully familiar with the contents thereof.
I give permission for the child named above to participate in the activities of CANYON CREEK CHURCH, including any special events/activities described above. In consideration for allowing the participation of the child in the activities of CANYON CREEK CHURCH, I hereby consent to the Permission/Waiver Form, including the Release of Liability above, on behalf of the child, and agree that this Permission/Waiver Form shall be binding upon me, my family, heirs, legal representatives, successors, and assigns.
I also understand that it is my responsibility to see that the information on this form is updated when there are any changes in my child’s/youth’s medical status, etc.
Young Person’s Agreement
I agree to participate in the functions and activities of CANYON CREEK CHURCH, to cooperate with the leaders and other young people and to conduct myself as a Christian. I promise to respect God, other persons, and property. I understand that my continued participation depends on my support of this agreement.