Trinity Harbor Youth Parent Authorization Form
Please read and respond to all statements below and provide your electronic signature prior to submitting this form. The parties agree that this document may be electronically signed. This form is in effect for the entire Trinity Harbor Youth Ministry year 2021-2022.


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I understand that I am enrolling my child in the Trinity Harbor Youth Ministry Program. *
Required
Child's Last Name *
Child's First Name *
As the parent or legal guardian of the child named above, I give this child permission to attend and participate in Harbor Youth Ministry activities. *
If a medical emergency arises, the Trinity Harbor Youth staff or volunteer/mentor will first attempt to contact me. If I cannot be reached, the staff will contact individuals I have named as emergency contacts. If the emergency is such that immediate hospital attention is necessary, an ambulance or emergency vehicle may take my child to the hospital. *
Required
I understand every effort will be made to contact me in the case of an emergency.  If needed, Trinity staff will obtain immediate medical attention for my child.     *
Required
I understand that Trinity does not provide any type of health or accident insurance for injuries incurred by my child while at Trinity Harbor Youth Ministry. *
Required
I understand policies are subject to change. *
Required
I give permission for my child to participate in all events and activities that are not on the Trinity campus.Youth may travel via walking, Trinity van, shuttle, or school bus.   *
Required
I give permission for any picture or video taken of my child to be used in Trinity social media posts, publications, in newspapers, on bulletin boards, or for Trinity training or marketing purposes. *
Required
Type Signature below (The parties agree that the electronic signatures appearing on this document are the same as handwritten signatures for the purposes of validity, enforceability, and admissability). *
I agree not to hold Trinity Lutheran Church liable for any injuries incurred by minor listed on this form. *
Required
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