Guest Event Waiver Form

Event Name (required)

Event Date (mm/dd/yyyy)(required)

Youth Name (required)

Youth Health #

Health Concerns (Allergies)

Parent/Guardian Name (required)

Parent/Guardian Phone

By CHECKING this box, I agree to the following statements.

Parent of participant UNDER the age of 18

By CHECKING the above box on the waiver form…

I grant permission for the child named above to participate in and engage in the Martensville Baptist Church youth group events. My child is physically and mentally able to participate in these activities, unless I have already discussed it with one of the leaders. I acknowledge that there are certain risks involved in said activities, and have discussed them with my child if necessary.

I release Martensville Baptist Church, its affiliates, volunteers, and employees of all responsibilities for any injuries, to body or property, which may occur to my child during the course of these activities. In the event of an emergency in which I, or the alternate contact, cannot be reached, I authorize the adult leaders to make medical decisions for my child, and to administer first aid if deemed necessary.

I further agree to indemnify and hold harmless Martensville Baptist Church and its affiliates, volunteers, and employees of any and all claims arising from the participation of my child in activities or as a result of injury or illness of my child or mine during such activities.

Participant will read the following rules:

1. I will not possess or use any drugs, alcohol or tobacco. If I take any prescribed medications a parent/guardian will notify a pastor.

2. I understand sleeping will be in separate designated areas for men and women. I will abide by that rule.

3. I will remain in the designated event areas and will not go into off limit areas set by the leaders.

4. I will behave appropriately with members of the opposite sex. I understand that public displays of affection will not be tolerated.

5. I will be obedient at all times. I will not argue with sponsors or event staff. I will follow their instructions.

6. I will dress modestly at all times. If I am unsure what modest is I will consult a sponsor.

7. I will be respectful and mindful of the facilities and the event schedule.

8. Verbal or physical Bullying WILL NOT be tolerated.

9. I will arrive on time to scheduled events/sessions.

I agree that my child has read the above rules and he/she has agreed to abide by them.

I understand that while my child participates in any church-sponsored activity, he or she is responsible to abide by the rules set forth by the church, its leaders and supervisory personnel. Any serious infraction of these rules and /or leadership by the youth can result in dismissal from the event or program. If my student is dismissed from the event, I agree to assume the cost of returning him or her home, and of any damages, which may have been caused by my teen.

I represent that I am the parent/guardian of the child named above, who is under 18 years of age. I have read the statements above and I give permission for the child named above to participate fully in the activities of Martensville Baptist Church.

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