Skiff Youth Group PARENTAL CONSENT & MEDICAL AUTHORIZATION 2026-2027

Please Fill out this sheet for each child in your family that will be attending Skiff Lake Bible Church Youth Group

Student Information

Name

Age

Birthday

Grade

School

Address

Parent(s)/Guardian Information

Parent(s)/Guardian

Parent/Guardian Contact Number: Name and Number

Emergency Contact: Name and Phone Number

Medical Information

Is your child presently being treated for an injury or sickness, or taking any form of medication for any reason?

Yes No

If Yes, Please explain

Is your child allergic to any medication, insect bite, or food?

Yes No

If Yes, Please explain

Medical Treatment Authorization

I understand that every reasonable effort will be made to contact me immediately in the event of a medical emergency involving my child. If I cannot be reached, I authorize the adult leaders of the youth ministry to obtain emergency medical treatment for my child, including transportation to a medical facility, and I authorize licensed physicians and medical personnel to provide any medical care they deem necessary. I understand that Skiff Lake Bible Church, its staff, volunteers, and adult leaders will not be responsible for any medical expenses incurred as a result of treatment, and I agree that all such expenses are my responsibility as the parent or legal guardian. I agree to notify the church of any changes in my child's health, medical conditions, medications, allergies, or physical limitations that may affect their ability to safely participate in youth activities. I understand that the adult leaders reserve the right to limit or restrict my child's participation in any activity if, in their judgment, participation may pose a risk to my child's health or safety, or the safety of others.

Yes

Transportation Authorization

I authorize my child to travel with Skiff Lake Bible Church staff members, volunteers, or other adults approved by the church for transportation to, from, and during any church-sponsored youth ministry activity or event. This authorization applies to transportation in church-owned, rented, or privately owned vehicles operated by approved adult drivers. I understand that reasonable precautions will be taken to ensure my child's safety during transportation, and I consent to my child's participation in all such transportation associated with youth ministry activities.

Yes

Media Authorization

I understand that photos and/or videos may be taken of my child during this camp for church use (slides, website, social media, etc.). I agree to expressly release Skiff Lake Bible Church (including her directors, membership and staff) from any and all claims which I may have for invasion of privacy, right of publicity, defamation, copyright infringement or any other causes of action arising out of the use, adaptation, reproduction, distribution, broadcast or exhibition of such photographs, videos, voice recordings and the like.

Yes

*To ensure the privacy of individuals and children, images will not be identified using full names or personal identifying information without written approval from the photographed subject, parent or legal guardian. **Skiff Lake Bible Church reserves the right to use any photograph or video taken at any service on church grounds, or event sponsored by Skiff Lake Bible Church, without the expressed written permission of those included within the media form.

Student Behavior and Parent Acknowledgment

I understand that my child is expected to conduct himself or herself in a manner that reflects Christian values and demonstrates respect for church staff, volunteers, fellow students, and others while participating in Skiff Lake Bible Church youth ministry activities. I understand that my child is expected to follow the instructions of adult leaders, respect church property and the property of others, and participate in activities in a safe and responsible manner. I understand that inappropriate behavior, including but not limited to bullying, harassment, fighting, disruptive conduct, inappropriate language, possession of prohibited items, or any behavior that jeopardizes the safety or well-being of others, may result in disciplinary action. I acknowledge that church staff and adult leaders reserve the right to determine appropriate disciplinary measures, which may include restricting my child's participation in an activity, contacting me to pick up my child from an event, or suspending my child from future youth ministry activities when deemed necessary.

Yes

Communication Acknowledgment

I understand that Skiff Lake Bible Church Youth Ministry communicates with parents and students through a variety of methods, including email, text messages, printed handouts given directly to students, and the church's youth ministry Facebook group. These methods may be used to share schedules, event information, reminders, permission forms, cancellations, emergency notifications, and other ministry-related updates. I acknowledge that it is my responsibility to ensure that the contact information I provide remains current and to regularly monitor these communication methods so that I receive important information regarding my child's participation in the youth ministry.

Yes

Consent & Certification

I, being the parent or legal guardian of the child named above, give permission for my child to participate in all regularly scheduled and special youth ministry activities sponsored by Skiff Lake Bible Church during the current ministry year. These activities may include, but are not limited to, youth group meetings, Bible studies, service projects, bonfires, swimming, sporting and recreational activities, lock-ins, concerts, conferences, retreats, camps, mission or outreach opportunities, transportation to and from activities, and other church-sponsored events. I certify that my child is physically able to participate in these activities, except as otherwise disclosed on this form. I agree to notify the church of any medical conditions, physical limitations, or other health concerns that may affect my child's ability to safely participate. I understand that church staff and adult leaders reserve the right to limit or restrict my child's participation in any activity if they believe participation could present a risk to my child's health or safety or the safety of others.

Yes

Email Address (Communication Purposes)

Please provide your primary email address to receive youth ministry updates, event information, reminders, schedule changes, permission forms, and other important announcements.

Parent/Guardian Email:

This address will receive a confirmation email

Signature

By typing my name below, I acknowledge that it constitutes my electronic signature and that I have read, understand, and agree to the terms and authorizations contained in this Youth Ministry Registration and Consent Form.

Date

Future Youth Ministry Scheduling

As we continue to grow our youth ministry, we are exploring the possibility of adding an additional weekly youth gathering. We would appreciate your feedback as we consider what might work best for our families.

If an additional weekly youth gathering were offered, which evening would work best for your family?

Please select one Sunday Monday Tuesday Thursday Friday We would not be able to attend an additional weekly gathering.

Would you be interested in providing a meal or snacks for youth group? Yes

Skiff Youth Group PARENTAL CONSENT & MEDICAL AUTHORIZATION 2026-2027

Description

Please Fix the Following