2022-2023 Youth & Family Ministries Blanket Permission & Release Form
This Permission, Release, Emergency Contact and Health Form shall be valid from July 1, 2022, to July 31, 2023, and only needs to be filled out and submitted one time for the 2022-2023 school year.
I understand that the First United Methodist Church, Schuylkill Haven, its staff, and volunteers, are committed to safe, fun, and educational activities, and that all activities are conducted in a smoke, alcohol, and drug-free environment. To help ensure the safety of all concerned, I understand that if my child or teen is in possession of illegal drugs, alcohol, or tobacco products, engages in any illegal conduct or refuses to follow the directions of the Youth staff or volunteers participating in the scheduled activities for 2022-2023, that I will be telephoned immediately to pick up my child. Although minimal, I am aware that some activities or events may involve physical activity where my child may be at risk for physical injury (running outside, ball tag, capture the flag etc.)
I agree to hold First United Methodist Church, Schuylkill Haven, its staff, and volunteers harmless should any such injury occur.
In the event of a medical emergency, I declare that I am the child or teen’s parent or legal guardian and hereby authorize the First United Methodist Church youth ministry staff or volunteers, as agents for me, to consent to medical attentions as advised and supervised by professional nurses, doctors or dentists should I be absent or unavailable to make such decisions. This authorization extends to any emergency room admission and treatment as an inpatient, considered necessary by the attending physician. I understand that, in such an emergency, I will be contacted as soon as possible.
I hereby hold the First United Methodist Church staff, volunteers, event staff and their representatives harmless in the exercise of this authority.
It is my understanding that the below
named student will be covered by my personal medical insurance.
I give permission for my child to be transported in vehicles operated by adults in whose care the minor has been entrusted while attending and participating in FUMC's iGnite Youth Ministry events.