2023-2024 Youth Activates Permission Form

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To participate in Youth events with the Student Ministry at Berean Community Church we ask each student to have completed a permission form by a parent. This ensures a release of liability and and provides important information for contacting parents in any event necessary. Please complete the form below and it will be sent to Berean Staff.

Youth Name *

Birth Date *

YYYY

Address

City

State

Zip

Phone *

Photo Limitation

I DO NOT give permission for my child’s image to be posted on the Berean website/social media pages

Clear selection

We, the parent(s)/guardian(s) do hereby give consent for our son/daughter to participate in Berean Community Church youth activities. Furthermore, we also give our consent for our son/daughter to walk, or ride in the designated vehicle(s) of Berean Community Church, to get to all the appointed destinations during these activities. I give permission for my Child's image to be posted on the Berean Church website/social media pages unless expressed in the photo limitation. *

I give consent

Name of Parent(s)/Guardian(s) giving consent: *

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