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Youth Permission Form
Mariana Garcia
August 25, 2023
August 25, 2023
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Step
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Youth Permission Form
Ministry Name
*
SELECT ONE
Adoption & Foster Care Awareness Ministry
Adult Usher Ministry
Alpha and Omega Steppers
Another Chance Ministry
Bereavement Ministry
Caregiver’s Support Ministry
Children and Youth Ministry
Christian Discipleship Council
Church Heritage Ministry
Church Women United
Deaf Ministry
Emerge Young Adult Ministry
Employment Services Ministry
Entrepreneurs Ministry
Fine Arts in Metropolitan and Its Environment (FAME)
Greeters Ministry
Health and Wellness Ministry
Hearts and Flowers Senior Ministry
HIV/AIDS Ministry
IAMA Counseling Ministry
Leslie Moreno Girl Scouts Ministry
Marriage Enrichment Ministry
Matthew 25 Ministries
Metropolitan Music and Arts Ministries
Mighty Men’s Ministry
Multimedia Ministry
New Disciples Ministry
Pastor’s Partners
Photography Ministry
Pray Until Something Happens (PUSH) Ministry
Social Justice and Public Policy Ministry
Sunday School Ministry
Temple Sentinels
The H. Beecher Hicks Jr. Reading Library
Toastmasters
Transportation Ministry
Veterans Ministry
Women’s Ministry
Youth Usher Ministry
Sub-Ministry Name
SELECT ONE
Metropolitan Music and Arts Ministry Praise Team
Metropolitan Music and Arts Ministry Chorus Choir
Metropolitan Music and Arts Ministry Consolation Choir
Metropolitan Music and Arts Ministry Mighty Men
Metropolitan Music and Arts Ministry Senior Choir
Metropolitan Music and Arts Ministry Young & Adult Fellowship Ensemble
Metropolitan Music and Arts Ministry Magnificat
Metropolitan Music and Arts Ministry Joyful Sound
Metropolitan Music and Arts Ministry Resounding Praise
Metropolitan Music and Arts Ministry Alpha & Omega Adult Step Team
Metropolitan Music and Arts Ministry Cherubs
Metropolitan Music and Arts Ministry Holliman Memorial Children’s Choir
Metropolitan Music and Arts Ministry Young Peoples Choir
Matthew 25 Ministries Eighty and Older Luncheon
Matthew 25 Ministries Gifts from the Heart
Matthew 25 Ministries Global Missions
Matthew 25 Ministries Safeway Feast of Sharing
Matthew 25 Ministries Street Ministry / Central Union Mission
Matthew 25 Ministries We Are One Body Food Pantry
Matthew 25 Ministries Another Chance
Matthew 25 Ministries Church Women United
Matthew 25 Ministries Social Justice and Public Policy
Staff Minister
*
SELECT ONE
Dr. Jesse L. Wood
Dr. Sherrill McMillan Duckett
Rev. Adriane Blair Wise
Rev. Brenda Girton-Mitchell
Reverend Kevin Gresham II
Youth Information
Name
*
Grade
DOB
Gender
F
M
Nickname
School:
Primary Address
Address Line 1
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Youth Email
Youth Home Phone
Youth Cell Phone
Parent/Guardian Information
Names(s)
Email 1
*
Email 2
List all Phone numbers where the parent/guardian can be reached (type i.e home, cell)
Name
#
Type?
Name
#
Type?
Name
#
Type?
Name
#
Type?
Emergency Contact
Name
#
Relation?
Name
#
Relation?
Next
Youth Name
*
Signature of Youth
Clear Signature
Date
Parent Name
*
Signature of Parent
Clear Signature
Date
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MEDICAL INFORMATION
YOUTH INFORMATION
Youth Full Name
*
First
Last
Nickname
Home Address
Address Line 1
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Home Phone
DOB
PARENT/GUARDIAN CONTACT INFORMATION
Parent/Guardian Name(s):
List all parent/contact phone #'s in order of best to be reached:
NON-PARENT/GUARDIAN EMERGENCY CONTACTS
Name:
Relation:
Phone(s):
MEDICATION:
Checkboxes
NO. Contact me or get medical help if my child has any minor medical concerns
Parent Typed Signature
Checkboxes
YES. I give permission for an adult youth leader to give my child approved over-the-counter medications as directed on an as needed basis to treat non-emergency medical conditions.
Parent Typed Signature
MEDICAL CONDITIONS: Please answer in detail if applicable or write N/A. Attach additional pages if necessary.
File Upload
List any medical conditions the youth has (asthma, diabetes, epilepsy, etc.):
List any allergies (drug/medicine, food, and/or environmental) and the severity and type of reaction:
Please explain any other pertinent info about the participant (physical, behavioral, or emotional) that would be important for the adult leaders to know.
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Next
Youth Participant's (or Adult leader's) Statement:
By signing this form, I pledge to honor God and respect others during this activity by following the rules and guidelines printed above. I understand that I cannot participate in the activity unless this completed form is on file.
Sig
Clear Signature
Youth Participant’s or Adult Leader’s Signature
Date
Parent/Guardian’s Statement:
By signing this form, I agree to support the ELEVATE Community Expectations printed above, and will accept responsibility for the payment of my child’s return transportation should s/he break one of the non-negotiable rules.
Sig (copy)
Clear Signature
Parent/Guardian’s Signature
Date
Church Photo Release Form for Children and Youth
1. Image means all photographs, film, or other recordings taken of you as part of the Shoot.
I agree that Metropolitan Baptist Church may photograph and record my child/dependent’s likeness and activities (Images) during church-related activities. I grant the following rights to Metropolitan Baptist Church: permission to use and re-use, publish and re-publish, and modify or alter the Image(s) taken during the shoot. Use of the Images for editorial, commercial, trade, advertising, and any other purpose may be done in any medium now existing or subsequently developed, on the church website and on the Internet, and worldwide in perpetuity for the purposes stated above. I waive my right to inspect or approve any editorial text or copy that is used in connection with the Images and release and discharge Metropolitan Baptist Church from any and all claims arising out of use of the Images for the purposes described above, including any claims for libel, invasion of privacy, or other tortuous act. I have read the foregoing. I fully understand its contents, understand that this agreement does not expire, and confirm my agreement by signing below. I am over the age of 21 and have legal capacity to sign the release.
Child/Youth's Name
*
Parent/Guardian Name
*
Parent/Guardian Signature
Clear Signature
Date
Submit