First Mennonite Church Youth Activities Permission & Consent for Treatment Form
Throughout the year youth involved in programs at First Mennonite Church have the opportunity to
participate in numerous activities, events, and trips, some of which are held on-site and some off-site.
Pastors and/or youth sponsors will communicate details of events beforehand, and will be available to
answer any questions you have regarding the activity. By signing this form and completing the
information on the back, you are giving permission for your child to participate in these activities;
however, some activities may require a separate permission slip, which will be communicated
beforehand.

As the parent or legal guardian, I consent to my child’s participation in activities offered by First Mennonite Church. I understand all reasonable safety precautions will be taken at all times by the leadership of these activities, which includes the abuse prevention guidelines outlined in the Keeping FMC Safe Policy. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. Further, I personally assume, on my child’s behalf, all liability in connection with said activities for any harm, injury, or damages
that may befall my child as a result of my child’s participation in the activities.

I also hereby give permission for my child to ride in any vehicle driven by an approved and
licensed adult chaperone while attending and participating in activities sponsored by First
Mennonite Church. My child and I understand that seat belts must be worn at all times during
transportation.

I understand that in addition to filling out the reverse side of this form, it is my obligation to
inform and update the church of any and all health considerations or medical conditions that
would restrict my child’s participation in any and all activities, trips, and events of First Mennonite
Church.

Should the need for medical attention arise, the youth sponsors will attempt to contact me as
soon as possible. In the event my child becomes ill, is injured, or requires emergency medical
attention of any kind, I hereby authorize the adult chaperone(s) to arrange for transportation to
the nearest hospital/treatment facility. I give permission for a licensed doctor or healthcare
professional to provide any and all medical care they deem, in their professional opinion, to be
necessary. I understand that I will assume full responsibility for all medical expenses incurred as
a result of the use of this consent.
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Parent/Guardian Name and Date
(Parental consent will be valid for one year, at which time an updated form and consent will need to be completed.)
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