Permission/Release Form

Kirkwood United Church of Christ Permission/Release Form

This form allows a partent our guardian to grant a (“Youth”) has permission to attend the following event organized or sponsored by, or participated in by, Kirkwood United Church of Christ (“Church”):
  • Event Details

  • Read Carefully

    This Permission/Release Form gives permission to seek medical attention as deemed necessary and releases the Church and others from any liability with respect to any injury, loss or damage to person or property with respect to the Youth named above. I, the undersigned, am the parent of, or the legal guardian of, the Youth named above, a minor, and have given my consent and permission for the youth to travel to and attend events organized or sponsored by, or participated in by, the Church (“Events”). I understand that there are inherent risks involved in the Events, and I hereby release the Church and its pastors, employees, agents, members and volunteers (together, “Church Persons”) from any and all liability for any injury, loss, or damage to person or property that may occur during the course of the Youth’s participation or involvement in the Events. If the Youth requires medical attention, I consent to such medical treatment as deemed necessary by Church Persons. If treatment is required by a doctor and/or hospital, I hereby agree to hold the Church and the Church Persons harmless from any and all liabilities, claims, demands or suits for damages arising from the authorization of such treatment as well as all costs of the medical treatment. I affirm that the health insurance information I have provided to the Church is accurate as of and will be in force for the Youth attending the Events. I agree that I will be responsible for bringing the Youth home at my expense should the Youth become injured or ill or if deemed necessary by Church Persons.

    I further authorize the Church and Church Persons to require compliance by the Youth with the Covenant made above by the Youth, and the Church and the Church Persons may send the Youth home at my expense if the Youth does not act in accordance with the Covenant.

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