As a parent/legal guardian of the student listed above, I have reviewed the information about the
activity/event and given my permission for the subject of this release to be involved in the overall activities.
I/We understand that in the event medical intervention is needed, every attempt will be made to contact immediately the person listed on the form. In the event I cannot be reached in an emergency during the activity dated shown on this form, I hereby give my permission to the physician or dentist selected by the activity leader to hospitalize, to secure medical treatment and/or to order an injection, anesthesia, or surgery for my child as deemed necessary.
I/We understand all reasonable safety precautions will be taken at all times by Kentucky Road Christian Church and its agents during the events and activities. I/We understand the possibility of unforeseen hazards and know the inherent possibility of risk. I/We agree not to hold Kentucky Road Christian Church, it leaders,
employees, volunteers staff liable for damages, losses, diseases, or injuries incurred by the subject of this form.
I/We agree to comply to the electronic device policy of Kentucky Road Christian. I/We understand that refusal to comply to these rules will result in the confiscation of my personal electronic device and will be given back only at the end of the trip and to the parents. I/We also understand that if I/we do not relinquish my electronic device when asked, I/we may be sent home at the discretion of the Youth Minister and Youth Sponsors and at the my/our own expense. I/We also understand that Kentucky Road Christian Church and its sponsors is not responsible for any lost or damage devices along the course of the trip.
I/We release any rights to the photos of me/my child to be used in the promotion of NYR and Kentucky Road Christian Church. This includes, but does not limit the use of these photos in printed publication or online media such as Facebook or kentuckyroad.org and any other form Kentucky Road Student Ministries feels necessary.
I/We understand that if any of the following rules are broken while on this trip I/we will be sent home at my/our own expense. This includes having no Alcohol, drugs, or tobacco or using them while on this trip. It includes not going into the sleeping quarters of a member of the opposite sex at any time. I/we shall attend all class sessions, worship sessions, and campfires. I/we will work with our designated workgroup assignment on all tasks when asked. I/we will abide by the curfew rules and remain at the campsite during curfew hours in my tent until the morning.