MYM and NCCC: Medical and Permission Form
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Email *
Parent or Guardian's Name *
Child's Name *
Child's Birthday *
MM
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DD
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YYYY
Home Address *
Known Allergies
Emergency Contact (Name and Phone Number) *
Secondary Emergency Contact (Name and Phone Number) *
Medical Insurance Company *
Policy # *
My child and I have reviewed and agree to the following Code of Conduct *
In order for the Meadowlark Youth Ministry to promote physical, psychological and spiritual safety and growth, the following expectations must be agreed to in order to participate in youth group activities:  Respect all persons and property.  Refrain from put-downs.  Extend politeness to all in our group and to everyone we meet. Be supportive of all members of the group.  Serve one another in Christian love. Wear seat belts when traveling in a vehicle.  Participate fully in activities unless the person is ill. Do not go off by yourself or with a group without Sponsor permission. Tell a Sponsor if you think someone may be an imminent danger to him/herself or others. During events, students are strictly prohibited from: Smoking or Vaping, Possession or use of alcohol or illegal drugs, Abuse of legal or prescription drugs, Sexual intimacy or excessive displays of affection, Sexual harassment, Possession of firearms, Fighting or arguing with other youth or leaders, Explicit language, and Bullying, and destruction/defacement of property. Additional Information: Failure to adhere to any of the above expectations may result in the student being disallowed from participation in a particular activity. If at any time, a student's behavior poses a threat to the safety of him/herself or others, the student may be immediately removed from the group and sent home at the parent's expense.Please note: students are encouraged to bring friends to Youth Group or NCCC, but they will be subject to the expectations outlined above.
Required
Release of Liability *
I hereby release the Meadowlark Church of Christ, its elders, and/or their designee(s), including Northern Colorado Christian Camp, from any liability that may occur causing medical attention for my child during any church-related activities involving my child.
Required
Consent to Use Images or Video *
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