If above is a student: The student named above has my permission to attend all scheduled youth activities sponsored by Community Bible Church (herinafter the "Church") during the specific time per noted on this form. I/We also give permission for my child to travel by bus, van or car to and from these Church sponsored activities. 

I, the undersigned, have legal custody of the child named above, a minor, and have given our consent for him/her to attend events being organized by the Church. I understand that there are inherent risks involved in any ministry or athletic events, and I/we hereby release the Church, it's pastors, employees, agents, and volunteer workers from any and all liability for any injury, loss, or damage to person or property that may occur during the course of my child's involvement. Activities may include, but are not limited to: surfing, swimming, basketball, roller skating, rollerblading, games in the park, soccer, volleyball, softball, baseball, indoor rock climbing, paintball, laser tag, mission projects, hiking and Bible studies. 


Note: If you desire to limit your child's participation in any event, please state those limitations in writing. 

In the event that he/she is injured and requires the attention of a doctor, I/We authorize a representative of the Church to make arrangements as she/he deems necessary for my child to receive medical treatment, including necessary transportation (e.g. ambulance). I/We consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by the Church, I/we agree to hold such person free and harmless of any claims, demands or suits for damages arising from the giving of such consent. I/We also acknowledge that we will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance provider. Further, I/We affirm that the health insurance information provided above is accurate at this date and will, to the best of my/our knowledge, still be in force for the child named above. I/We also agree to bring my/our child home at my/our own expense should he/she become ill or if deemed necessary to the supevising youth staff member of the Church.