FPC Sarasota Youth Ministry Info and Permission Form
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Youth's Last Name *
Youth's First Name *
Birth Date *
Grade and School *
Youth Phone Number *
Youth Email *
Parent/Guardian #1 *
Parent/Guardian #1 Phone Number *
Parent/Guardian #2
Parent/Guardian #2 Phone Number
Preferred Parent/Guardian Email Contact *
Mailing Address *
Emergency Contact Name & Phone Number *
My child plans to attend Sunday school on a regular basis.  *
My child is interested in going to Montreat in Summer 2023. *
My child is interested in attending a confirmation class starting in January 2023.  *
What else would you like us to know about your child?
Are there any medical (physical or mental) needs that we need to be aware (allergies, medication, etc.)? Any special dietary restrictions? *
I give permission for FPC Sarasota to publish in News at First, the local newspaper, the bulletin board or FPC website any photos taken during Sunday school or other children's/youth programming  *
I grant permission for the above-named youth to participate in programming and events sponsored by the FPC Sarasota Children and Youth Program. On behalf of the child named above and of myself and my family, I acknowledge and assume that there may be risks and will not hold FPC Sarasota responsible for them, except to the extent that those with responsibility to supervise the children and youth during the events, and those responsible for operating such vehicles, should intentionally or negligently fail to use reasonable care in supervising or transporting the children.

In the event that I cannot be reached in an emergency, I give permission, for the leaders to obtain any medical help which appears reasonably necessary.

I have read and understand the foregoing Assumption of Risk and Medical Authorization.

Your name below will represent your signature in agreement to the above statement.
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