Youth Parent Form - Contact Information
Hey everyone,

Noah Bergmann here, as there are many new youth and therefore new youth parents I was hoping to get an updated set of contact information for each of the youth. Should something happen and we need to contact a parent I would like to be able to do so without trying to dig through information that may or may not be up to date. If you could just fill this out I would appreciate that, it's gonna be a bit detailed but I would like to make sure I get it all together in one go. If both you and and your spouse or ex-spouse regularly receive these emails only one response per youth family is required.

Note: this form does ask for private, personal information, that information may be shared with Ness Avenue Baptist Church Staff and Volunteers as needed, otherwise I will keep that information private.

Thank you very much,
Noah Bergmann
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Email *
Parent/Guardian Name (First and Last) *
Parent/Guardian Address *
Secondary Address (i.e.: if child(ren) go back and forth between divorced or separated parents)
Second Parent/Guardian Name (First and last)
Alternative Parent/Guardian Name (First and Last. Please also include relation to the child(ren) e.g.: grandparent, stepparent, other guardian)
Parent/Guardian Primary Phone *
Parent/Guardian Secondary Phone
Alternative Parent/Guardian Phone
Parent/Guardian Email (Yes, I know one was required to start the form. This could be an alternative email if you have another one, or if your spouse or ex-spouse has an email that is on our regular email list or that we should have, if no other email is applicable just retype the same one as before. Thank you for understanding) *
Parent/Guardian Medical and Liability Waiver:

I/we the parent(s)/guardian(s) of the subsequently named youth agree to idemnify and hold harmless Ness Avenue Baptist Church, it’s Staff and Leaders, from and against any loss, damage, or injury suffered by the participant as a result of being part of the activities of Ness Avenue Baptist Church (but not including cases of negligence or malicious intent), as well as of any medical treatment authorized by the supervising individuals representing Ness Avenue Baptist Church. I/we also agree to authorize Ness Avenue Baptist Church Personnel to sign consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above in the case of medical treatment being necessary.

Note: 
Of course in the case of any injury or where medical treatment would be necessary we would make every effort to contact parents and guardians (hence this contact form) and have them make any necessary decisions for their children.
*
Parent/Guardian Photo Waiver

I/we the parent(s)/guardian(s) of the subsequently named youth agree to allow photos of my/our youth for reasonable means (i.e.: posting on the wall of the youth room, the occasional social media post on official Ness Baptist social media, or for use on the Ness Baptist website) providing that the photos are 
*
Child First Name *
Child Last Name *
Child Birthdate *
MM
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DD
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YYYY
Child School *
Child Current Grade *
Child Allergies, Medical Concerns, and or Mental/Cognitive Disabilities (n/a if not applicable) *
Second Child First Name
Second Child Last Name
Second Child Birthdate
MM
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DD
/
YYYY
Second Child School
Second Child Current Grade
Second Child Allergies, Medical Concerns, and or Mental/Cognitive Disabilities (n/a if not applicable)
Third Child First Name
Third Child Last Name
Third Child Birthdate
MM
/
DD
/
YYYY
Third Child School
Third Child Current Grade
Third Child Allergies, Medical Concerns, and or Mental/Cognitive Disabilities (n/a if not applicable)
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