Medical Release Form/Permission Slip

Christ Chapel enjoys and prepares to take our students to camps and events off campus. In order to ensure the safety of our students we ask that every parent/ guardian have a medical release form filled out annually. Thank you for helping us to maintain the safety of your babies.
 
Student / Leader Information:

 
 
 
 
 
 
Medical Information:

 
 
 
 
 
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For your information, we expect each student to conform to these rules or conduct:

*No possession or use of alcohol, drugs or tobacco
*No students under the age of 18 can drive to events outside of the Middle GA area without written Permission
*No fighting, No weapons, No fireworks, No lighter, or explosives
*No boys in girls' sleeping quarters & No girls in boys' sleeping quarters
*Any irresponsible behavior is prohibited
*Participation with group is always expected
*Respect property, one another, staff & adult leaders
*Respect & comply with event rules and schedules


STUDENTS WHO FAIL TO COMPLY WITH THESE EXPECTATIONS MAY BE SENT HOME AT THEIR PARENTS' EXPENSE

 
Activity Permission Slip

In the event of sickness, injury or some medical emergency, I/we request that my/our child receive any medical attention to treatment deemed necessary. Therefore, I/we the parent(s)/guardian(s) give permission and hold harmless to any hospital, doctor, and/or health care provider to transport, treat, and/or admit for care my/our child. In the event that I/we are not present at the time of the emergency, my/our child's care has been entrusted to the staff and designated adult leader Christ Chapel Warner Robins while attending any youth function or activity both on and off church grounds. 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 company provided above is accurate at this date and will , to the best of my/our knowledge, still be in force for the student named above. I/we also agree to bring my/our child home at my/our expense should they become ill or if deemed necessary by the student ministries staff member.

I/we also release Christ Chapel, it's agents, assigns, staff, employees as well as volunteer workers form any liability whatsoever arising out of property damage or loss as well as injury, sickness or death which may be sustained by my/our child's the result of any participation in church sponsored or related function or activities.

 

Description

Christ Chapel enjoys and prepares to take our students to camps and events off campus. In order to ensure the safety of our students we ask that every parent/ guardian have a medical release form filled out annually. Thank you for helping us to maintain the safety of your babies.