Parkgate Student Ministry Medical Release Form 2019
By typing my name in the box below, I do hereby give consent to any medical, dental, or surgical treatment that the Parkgate Student Ministry Pastor and/or Adult Leaders from Parkgate Community Church, 3715 Preston Road, Pasadena, TX 77505 may deem necessary while participating in the below mentioned Parkgate Student Ministry sponsored activity. I understand that every conceivable effort will be made to contact me, the parent or legal guardian of the above mentioned student, before treatment is given. I do hereby assume all risks and I agree to release and hold harmless Parkgate Community Church of Pasadena, TX, its representatives, employees, and all related entities from any liability, loss or damage actions, claims and demands, which my child now has or that may arise from their participation in this activity.
Parkgate Community Church will be photographing/filming students throughout the year. By typing my name int he box below, I understand that my children's photographs may be presented in an array of multimedia formats both online and in print. This includes our Facebook Page, where I may be taggged.
By typing my name in the box below, I agree to uphold the responsibilities outlined in the Student Responsibilities section of the IMPACT Ministry Handbook.
By typing my name in the box below, I state that I understand that if my child is in violation of any of the named responsibilities, upon the decision of the Pastor of Student Ministries of Parkgate Community Church with consultation from another Student Ministry Staff member or the Senior Pastor, may be sent home at my expense. We, the above mentioned youth and parent/legal guardian have discussed the Student Responsibilities and understand what behavior is expected.