Elberton First Methodist Church

Student Ministry Permission/Release/Authorization Form

PARTICIPANT INFORMATION



Parent/Guardian Information

Household Address



EMERGENCY TREATMENT & TRANSPORTATION PERMISSION: In case of accident or injury, Elberton First Methodist Church requests parental and/or guardian permission for emergency treatment and transportation. A signature below grants this permission.

Permission/Release of Liability – I give permission for my child to participate in Elberton First Methodist Church (EFMC) Student Ministry activities.
I acknowledge that participation in trips/activities involves risk to the participant (and to the participant’s parents or guardians, if the participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, exposure to infectious/communicable disease, bodily injury, death, emotional injury, personal injury, property damage, property theft or loss, and financial damage. In consideration for the opportunity to participate in trips/activities, the participant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the activity.  
Further, the participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless EFMC for any injury arising directly or indirectly out of the activity or transportation to and from the activity, whether such injury arises out of the negligence of EFMC, the participant (or parent/guardian), or otherwise. I agree to waive and relinquish all claims against EFMC and its officers, agents, employees, volunteers, or any other representatives, and accept personal financial responsibility for any injury or other loss sustained during the activity or during transportation to and from the activity.

By signing below, I certify that all of the above information is true and correct, and I certify that I have read this document and fully understand its content.