Fall Retreat 2024 Permission & Release Form

Student's Name *

First Name

Last Name

Emergency Contact

First Name

Last Name

Emergency Contact Phone Number *

(###)

###

####

Can we text this number? *

If there's not an emergency, but we need to reach out to you regarding your student we may send an sms message

Yes

No

Photo/Media Release *

Do you grant permission for photos, videos, and social media posts of your student to be used by the student ministry for promotional and informational purposes? If not we will be diligent to not include their image in those materials.

Yes

No

Liability Release *

I give permission for my child to participate in Student Ministry activities at Fairfield Church of Christ. I release and hold harmless the church, its staff, volunteers, and leaders from any liability or claims arising from participation in these activities, including any injuries or damages that may occur.

Yes

No

Transportation Release *

I give permission for my child to be transported by Fairfield Church of Christ staff, volunteers, or designated drivers for Student Ministry activities. I release and hold harmless the church, its staff, volunteers, and drivers from any liability or claims in connection with transportation to and from these events.

Yes

No

Digital Signature Agreement *

"By inserting my name below, I acknowledge that I have read, understood, and agree to the terms outlined in this permission form. My digital signature confirms my consent and agreement, and serves as a legally binding equivalent to my handwritten signature."

Yes

No

Digital Sign Off *

This is for the parent/guardian of the student.

First Name

Last Name