YOUTH MEDICAL & PERMISSION RELEASE AGREEMENT
By signing below, I acknowledge and agree to the following:
1. Information Verification
I certify that the information provided on this form is true and accurate to the best of my knowledge. This release is effective from September 1, 2026, through September 1, 2027.
I understand that it is my responsibility to notify Christ the Rock Community Church of any changes to the information provided during that period.
2. Transportation Permission
I give permission for my student to be transported to and from Youth activities, events, and trips by approved Youth Leaders, approved Youth Volunteers, church staff, or licensed commercial transportation providers when necessary.
3. Medical Authorization
I authorize approved Youth Leaders, approved Youth Volunteers, or licensed healthcare professionals to administer over-the-counter medications as indicated on this form or otherwise approved by me. In the event of illness or injury, I also authorize licensed healthcare professionals to provide necessary medical treatment and to release medical information as needed for insurance and treatment purposes.
4. Prescription Medications
I understand that my student is responsible for administering their own prescribed medications unless other arrangements have been made in advance. I release Christ the Rock Community Church, its staff, and volunteers from responsibility for the storage or administration of prescription medications except in cases of gross negligence or willful misconduct, where permitted by law.
5. Medical Expenses
I accept financial responsibility for all medical expenses incurred as a result of my student's participation in Youth activities, events, or trips.
6. Assumption of Risk and Release
I understand that participation in Youth activities, events, trips, and transportation involves inherent risks. I voluntarily assume these risks on behalf of my student. To the fullest extent permitted by law, I release and hold harmless Christ the Rock Community Church, its employees, volunteers, and authorized representatives from liability for injuries or damages arising from participation in these activities, except in cases of gross negligence or willful misconduct.
7. Photo and Video Release
I grant permission for Christ the Rock Community Church to photograph or record my student during Youth activities and to use those images or recordings in print, online, social media, promotional materials, and other ministry-related communications without compensation.
8. Illness or Early Dismissal
I agree to arrange for my student to be picked up promptly, at my own expense, if they become ill, are injured, or if a Youth Leader determines it is in the best interest of my student or others for them to leave an activity.
9. Revocation of Authorization
I understand that I may revoke this permission and medical release at any time by providing written notice to Christ the Rock Community Church. Such revocation will apply only to future activities and not to actions already taken in reliance on this authorization.
10. Emergency Medical Care
If I cannot be reached in the event of a medical emergency, I authorize Christ the Rock Community Church to obtain emergency medical treatment for my student as deemed necessary by licensed medical personnel.
Electronic Signature
By signing electronically below, I acknowledge that I have read, understand, and agree to all of the above permissions, authorizations, and releases. I understand that my electronic signature has the same legal effect as my handwritten signature.
