PLEASE READ THE FOLLOWING AND FILL OUT THE INFORMATION BELOW:
The undersigned does hereby give permission for my child/children named below, to attend and participate in any Community Church of Mt. Pleasant(CCMP) TRIBE/youth ministry on-campus and off-campus activities, events, and retreats during the period of the calendar year 2022.
LIABILITY RELEASE: In consideration of CCMP/TRIBE Student Ministry allowing the Participant(s) to participate in youth ministry (Sunday evening gatherings, Activities, Events, Retreats, Lock-Ins, or Trips), I, the undersigned, do hereby release, forever discharge and agree to hold harmless CCMP TRIBE Student Ministry, its pastors, directors, employees, volunteers and teachers (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant(s) while involved in the youth activities. I, the parent or legal guardian of this Participant(s), hereby grant my permission for the Participant(s) to participate fully in youth ministry activities, including trips away from the church premises. Furthermore, I, on behalf of my minor Participant(s), hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein. The undersigned further hereby agrees to hold harmless and indemnify said Church for any liability sustained by said Church as the result of the negligent, willful or intentional acts of said Participant(s), including expenses incurred attendant thereto.
MEDICAL TREATMENT PERMISSION: I authorize an adult, in whose care the minor has been entrusted, to consent to any emergency x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care, to be rendered to the minor under the general or special supervision and on the advice of any physician or dentist licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital or emergency care facility. The undersigned shall be liable and agrees to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child/children pursuant to this authorization.
EARLY RETURN HOME POLICY: Should it be necessary for my child/children to return home due to medical reasons, disciplinary action or otherwise, the undersigned shall assume all transportation costs and responsibility.
TRANSPORTATION PERMISSION: The undersigned does also hereby give permission for my child/children to ride in any vehicle driven by an approved and licensed ADULT chaperone while attending and participating in activities sponsored by CCMP TRIBE student ministry. My child/children and I understand that SEAT BELTS MUST BE WORN AT ALL TIMES during transportation.
Please Read the following and acknowledge:
The undersigned acknowledges the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.
The undersigned further acknowledges that CCMP TRIBE student ministry has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19 by providing hand sanitizer and disposable masks.
The undersigned acknowledges that CCMP TRIBE student ministry cannot guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of child/children and others, including, but not limited to, volunteers, other attendees and their families.
The undersigned acknowledges that their child/children are voluntarily seeking to attend an activity/event hosted by CCMP TRIBE student ministry and acknowledge that they are increasing their risk to exposure to the Coronavirus/COVID-19.
I, the undersigned, attest that prior to any CCMP TRIBE Student Ministry event that their child/children:
* Are not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
* Have not traveled internationally within the last 14 days.
* Have not traveled to a highly impacted area within the United States of America in the last 10 days.
* Have not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
* Have not been diagnosed with Coronavirus/COVID-19 and not yet cleared as non-contagious by state or local public health authorities.
* Have been following all CDC recommended guidelines as much as possible and limiting their exposure to the Coronavirus/COVID-19.
Thank you for your cooperation.
LIABILITY RELEASE: In consideration of CCMP/TRIBE Student Ministry allowing the Participant(s) to participate in youth ministry (Sunday evening gatherings, Activities, Events, Retreats, Lock-Ins, or Trips), I, the undersigned, do hereby release, forever discharge and agree to hold harmless CCMP TRIBE Student Ministry, its pastors, directors, employees, volunteers and teachers (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant(s) while involved in the youth activities. I, the parent or legal guardian of this Participant(s), hereby grant my permission for the Participant(s) to participate fully in youth ministry activities, including trips away from the church premises. Furthermore, I, on behalf of my minor Participant(s), hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein. The undersigned further hereby agrees to hold harmless and indemnify said Church for any liability sustained by said Church as the result of the negligent, willful or intentional acts of said Participant(s), including expenses incurred attendant thereto.
MEDICAL TREATMENT PERMISSION: I authorize an adult, in whose care the minor has been entrusted, to consent to any emergency x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care, to be rendered to the minor under the general or special supervision and on the advice of any physician or dentist licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital or emergency care facility. The undersigned shall be liable and agrees to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child/children pursuant to this authorization.
EARLY RETURN HOME POLICY: Should it be necessary for my child/children to return home due to medical reasons, disciplinary action or otherwise, the undersigned shall assume all transportation costs and responsibility.
TRANSPORTATION PERMISSION: The undersigned does also hereby give permission for my child/children to ride in any vehicle driven by an approved and licensed ADULT chaperone while attending and participating in activities sponsored by CCMP TRIBE student ministry. My child/children and I understand that SEAT BELTS MUST BE WORN AT ALL TIMES during transportation.
Please Read the following and acknowledge:
The undersigned acknowledges the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.
The undersigned further acknowledges that CCMP TRIBE student ministry has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19 by providing hand sanitizer and disposable masks.
The undersigned acknowledges that CCMP TRIBE student ministry cannot guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of child/children and others, including, but not limited to, volunteers, other attendees and their families.
The undersigned acknowledges that their child/children are voluntarily seeking to attend an activity/event hosted by CCMP TRIBE student ministry and acknowledge that they are increasing their risk to exposure to the Coronavirus/COVID-19.
I, the undersigned, attest that prior to any CCMP TRIBE Student Ministry event that their child/children:
* Are not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
* Have not traveled internationally within the last 14 days.
* Have not traveled to a highly impacted area within the United States of America in the last 10 days.
* Have not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
* Have not been diagnosed with Coronavirus/COVID-19 and not yet cleared as non-contagious by state or local public health authorities.
* Have been following all CDC recommended guidelines as much as possible and limiting their exposure to the Coronavirus/COVID-19.
Thank you for your cooperation.