Hope Lutheran Church Youth Group        Permission Form 2021-2022
By signing this form, I give my son/daughter permission to attend and participate in both social, physical and virtual activities that may take place both on and off the church’s property and online.  These activities may include being with Hope’s youth group for a 1-5 day event.  This permission slip covers the 2021-2022 school year and is effective August 1, 2021 – July 31, 2022.  I understand I have the right to withdraw this permanent permission slip at any time in the future.  I/we realize my son/daughter’s participation in youth group activities is contingent upon the church having the appropriate consent form on file.  

By signing this form, I agree to drop off and pick up my child up at the times provided by the youth leaders.  If I am not able to pick-up my child, I will make arrangements with other parents or family members to do so.  If youth leaders determine they will not be returning to the church at the previously established time, they, or my child, will attempt to reach me with an updated time of arrival.  If I am late in bringing my child to an event, I understand the group may leave without him/her.  I also understand that if I am more than 15 minutes late to pick up my child, I will be contacted by the Youth Ministries Coordinator.  If, after a third occurrence of my child not being picked up in a timely manner, the youth group leadership has the right to not allow my son/daughter participation in the next event or activity.

I agree to sign in and sign out my child at the beginning and end of every youth group event. I understand if my child arrived at or left an event without a guardian signature, I will be contacted, at the discretion of the youth leaders, and may be asked to return to the church to sign the appropriate paperwork. I understand if someone else will be dropping off or picking up my child, I will inform the youth leaders before the event.

By signing this form, I permit youth leaders to contact my child at the information provided below. I understand by leaving these items blank youth leaders will not contact my child. Youth may be contacted through messaging apps and/or social media, approved by council, pertaining to church youth group events only.

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Youth First Name *
Youth Last Name *
Youth Birthdate
MM
/
DD
/
YYYY
Youth Age
Youth Grade
Youth Address
Youth Cell Phone (optional)
I allow my child to be contacted by Youth Leaders through text messaging/text messaging apps such as Group Me or Remind. Messages sent will only pertain to church and youth group related events. *
Youth Email (optional)
I allow my child's picture to be taken at Hope Lutheran Church events to be used in advertising and/or posted on the Hope Lutheran website, Facebook page, or other media outlets. I am aware that pictures may also be used/posted during worship services or in the church to promote youth activities. *
1. Parent/Guardian Name
1. Parent/Guardian Relationship
1. Parent/Guardian Address
1. Parent/Guardian Cell Phone
I agree to receive text messages with youth group event updates and reminders.
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1. Parent/Guardian Home Phone
2. Parent/Guardian Name
2. Parent/Guardian Relationship
2. Parent/Guardian Address                                  (if different than above)
2. Parent/Guardian Cell Phone
I agree to be contacted through text message to receive updates/reminders about youth group events.
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Preferred Email to receive notifications about youth group event. *
In case of emergency please contact: (Please include, name, relationship, address and phone number)
Please list any medical conditions, allergies or medications for your child.
I agree to allow my child to receive basic first aide if needed. This may include: Aleve, Tylenol, Motrin, Tums, Petpo-Bismal, Neosporin, etc.
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By typing my name below, I agree I am the parent/guardian of the above named youth and take responsibility for the accuracy of this form.
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