Ojai Presbyterian Church - Youth Permission and Medical Release Form

This form is a legal document that authorizes your child's participation in a wide variety of activities over the course of a one-year period. Please read this form carefully and clarify any concerns before signing. If you have any questions, please call the church office at (805) 646-1437.
 
 
Please select all that apply.
 
 
 
 
 
 
 
 
 
Medical Information & History
 
 
 
 
 
 
 
 
 
Please select all that apply.
 

-MEDICAL RELEASE:  In the event that I cannot be reached in an emergency during the dates specified on this form, I hereby give my permission to the physician or dentist selected by the church leadership to secure proper intervention, X-ray examination, medical or surgical diagnosis and treatment, anesthesia, and hospitalization for my son or daughter as deemed necessary.  Parents will be responsible for full-payment of all medical treatments.


-LIABILITY RELEASE: Signing of this form constitutes agreement by the parent/guardian to assume and accept all risks and hazards inherent in church-related programs, outings, and social activities and to release Ojai Presbyterian Church, its employees, Board, Agents, Volunteer Assistants, and all other persons or entities, including other participants, from any and all liability for damages, losses or injuries to the person or property of the undersigned.   The parents or guardians understand that they are signing for the minor(s) listed on this form and the signature is for both a medical and liability release.


-SCOPE OF EVENTS: My child has permission to attend all church sponsored youth/children’s activities, including, but not limited to, the following list:  Cook-outs, boating, water sports (including water skiing, wakeboarding, banana boating, kneeboarding) basketball, roller skating, roller-blading, skateboarding, broomball, games in parks, soccer, volleyball, softball, baseball, water parks, amusement parks, camping, retreats, repelling, whitewater rafting, rock climbing, hiking, biking, skiing and/or snowboarding, sports, concerts, Bible studies, miniature golf, etc.  NOTE:  If you desire to limit your child’s participation in any event, please inform OPC in writing in advance of that event.


-RULES OF BEHAVIOUR EXPECTED FROM EACH STUDENT:  1) No alcohol, drugs, tobacco permitted. 2) Participation with the group is expected.  3) Respect others, staff, adult leaders, and property.  4) Respect and comply with event schedules.  5) No, iPods or tablets except when permitted etc.  FAILURE TO COMPLY WITH THESE EXPECTATIONS COULD RESULT IN YOUR CHILD BEING SENT HOME AT YOUR EXPENSE.  Specifically, this means you may be required to pick up your child at any activity and forfeit any payment made for the camp or activity.

Please select all that apply.
*This allows us to provide students with photos and video of the trip. It also helps us with our local promational materials. We want to be sensitive with the use of such footage and will not publish student names with photos. Please do not hesitate to contact Megan Babayco with any questions or concerns--megan@ojaipc.org
Please select all that apply.
 
*By entering my name in the box above, I am providing my digital signiture on this Form. 

Description

This form is a legal document that authorizes your child's participation in a wide variety of activities over the course of a one-year period. Please read this form carefully and clarify any concerns before signing. If you have any questions, please call the church office at (805) 646-1437.