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Student Permission Form
If you are attending any Red Bank Student Ministries event or trip, please fill out the following information. This form must be completed annually.
Student's First Name
Student's Last Name
Student's Email
Student's Birthday
Parent's First Name
Parent's Last Name
Parent's Email Address
Parent's Phone Number
I grant permission for my child, named above, to participate in any and all Red Bank Baptist Church sponsored events during the calendar year 2022. I understand that this activity will take place under the guidance and direction of employees and/or volunteers of the above organizations.
I agree on behalf of myself, my child’s other parent or guardian, my child named herein, or our heirs, successors, and assigns, to release, waive, indemnify and hold harmless and defend the Red Bank Baptist Church, their employees, volunteers, or other agents with respect to any and all actions, claims or demands that may be made or brought against them.
I hereby warrant that to the best of my knowledge, my child is in good health, and I assume all responsibility for the health of my child. I acknowledge that a current Medical Consent Form is on file with Red Bank Baptist Church.
Red Bank Baptist Church will not be held liable for any valuables lost or stolen at the event described above.
I understand and agree that this release is required as contractual consideration to the Red Bank Baptist Church for allowing my child to participate in this youth ministry event, and that my agreeing to this release of liability is a required prerequisite in order for my child to participate in the above described youth ministry event.
To the best of my knowledge, my child is in good health. In the event of circumstances which indicate that my child is in need of medical care, I authorize Red Bank Baptist Church representatives to consent to any necessary X-ray examinations, medical or surgical diagnosis, treatment, medication, or hospital care in accordance with standard medical practice by licensed medical personnel. I release and agree to hold Red Bank Baptist Church their employees and volunteers harmless from any claims due to illness or injury suffered by my child in the course of receiving such medical responsibility and consequences that may arise as a result of this treatment.
Child's Insurance Information
Current Prescription and Allergy Information
Submit
