I hereby give permission for Youth or Child (Name): *
to attend (name of event): *
In case of emergency, please contact: *
It is assumed that all due care and precaution will be taken by the First United Methodist Church staff and members in attendance at the above stated event. Beyond that, the First United Methodist Church will assume NO responsibility.
Does your youth have any known allergies? *
Please list any known allergies:
Will your youth be taking any medication during event? *
Please list medications:
Ibuprofen or acetaminophen can be administered to my youth if requested for minor aches or pains. *
An updated Registration Form for Children and Youth for my youth is on file in the church office. *
I give my consent for any pictures taken of my youth at the above stated event to be shared in any future youth publications and/or on the church’s website. *
Parent/Guardian Signature (typing name will indicate a signature) *
I understand that my behavior is either a positive or negative reflection of Chelsea First United Methodist Church, agree to participate to the fullest of my ability, and to follow the rules of the event.
Child or Youth Signature: *