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List AT LEAST two emergency contacts. Include: NAME / NUMBER/ RELATION

The undersigned does hereby give permission for my child ____________________________ (child’s name)(“Participant”), to attend and participate in any FWC children/youth ministry activities, events, retreats and childcare during the period of July 2021-July 2022.

LIABILITY RELEASE: In consideration of FWC allowing the Participant to participate in children/youth ministry (Sunday worship, Sunday meeting, Activities, Events, Retreats, Lock-Ins, Trips) and childcare, I, the undersigned, do hereby release, forever discharge and agree to hold harmless FWC, its pastors, directors, employees, volunteers and teachers (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness, including COVID or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in the children/youth activities and childcare. I the parent or legal guardian of this Participant hereby grant my permission for the Participant to participate fully in children/youth ministry activities and child care, including trips away from the church premises. Furthermore, I, on behalf of my minor Participant, hereby assume all risk of accidental personal injury, sickness, including COVID, death, damage and expense as a result of participation in recreation and work activities involved therein. The undersigned further hereby agrees to hold harmless and indemnify said Church for any liability sustained by said Church as the result of the negligent, willful or intentional acts of said Participant, including expenses incurred attendant thereto.

MEDICAL TREATMENT PERMISSION: I authorize an adult, in whose care the minor has been entrusted, to consent to any emergency x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care, to be rendered to the minor under the general or special supervision and on the advice of any physician or dentist licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital or emergency care facility. The undersigned shall be liable and agrees to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child or youth pursuant to this authorization.

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Please answer in detail if applicable or write N/A.

VBS is a safe and inclusive environment for all children, staff is vetted and trained for this ministry. The desire is for every child to have a fun and spiritually fulfilling week learning more about Jesus. To that end, my child will behave in a respectful and kind manner, obedient to staff instructions. Bullying and physical violence will NOT be tolerated in anyway. All participants MUST use the restroom that matches their biological gender. Violation of any of these guidelines is grounds for immediate dismissal and exclusion from all activities and it will be my responsibility, as the parent or legal guardian, to arrange immediate pick-up and removal of my child, without exception.

I agree that FWC may photograph and record my child/dependent’s likeness and activities (Images) during church-related activities. I grant the following rights to FWC: permission to use and re-use, publish and re-publish, and modify or alter the Image(s) taken during the shoot. Use of the Images for editorial, commercial, trade, advertising, and any other purpose may be done in any medium now existing or subsequently developed, on the church website and on the Internet, and worldwide in perpetuity for the purposes stated above.

I waive my right to inspect or approve any editorial text or copy that is used in connection with the Images and release and discharge FWC from any and all claims arising out of use of the Images for the purposes described above, including any claims for libel, invasion of privacy, or other tortuous act.

I have read the foregoing. I fully understand its contents, understand that this agreement does not expire, and confirm my agreement by signing below. I am over the age of 21 and have legal capacity to sign the release.

By submitting this form electronically, I am agreeing to the terms and conditions herein. My email is my electronic signature and by clicking on the SUBMIT button, I am signing this consent form.