First United Methodist Church

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Please monitor your health and if you are not feeling well or exhibiting COVID-19 symptoms, we ask that you refrain from attending youth ministry.

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I have read the above guidelines and agree. Yes

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2024-2025 Youth Information /Liability Form

Parent's Information:

Parent's Name or Legal Guardian (required)

Address (required)

City (required)

Cell Phone (required)

Email (required)

The best way to communicate youth events and gathering reminders: EmailText

Person to call in case of Emergency: (required)

Emergency Phone Number (required)

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Child(ren)s Information:

Name: text firstchildname] Grade Fall of 2024 —Please choose an option—6789101112

Name: Grade Fall of 2024 —Please choose an option—6789101112

Name: Grade Fall of 2024 —Please choose an option—6789101112

Name: Grade Fall of 2024 —Please choose an option—6789101112

Name: Grade Fall of 2024 —Please choose an option—6789101112

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Any medical conditions we should be aware of, such as allergies, etc? Please specify which child and what we should know.

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I hereby give permission to use my child's/children's photos for any promotional material including the church's website, Facebook page and newspaper. YesNo

I give permission for my child/children to ride in a vehicle to youth events with an adult with valid driver’s license. YesNo

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MEDICAL TREATMENT RELEASE AND LIABILITY RELEASE

I, the undersigned parent or guardian do hereby grant permission for (child's/children's name) to participate in the Youth Group Activities at the First United Methodist Church (FUMC) in Wood River. I hereby authorize the staff, leaders, and volunteers to obtain and consent to medical treatment for my child in case of injury or illness. I further hereby release and discharge the staff, leaders, and volunteers of the FUMC from any and all debts, judgments, or suits of any kind which may arise or be occasioned as a result of my child’s participation in the Youth Group Program.

I further acknowledge and understand that by participating in this program, there is a possibility of physical illness or injury and my child is assuming the risk of such illness and injury by his/her participation. It is my understanding that payment of any medical bills will be paid by me or my insurance company.

By entering my name below I agree to the statement above and understand that it is the same as signing a document:

Name:
Date:

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