Youth Permission Form - Metropolitan Baptist Church

Step 1 of 4

Youth Permission Form

Ministry Name *

Sub-Ministry Name

Staff Minister *

Youth Information

Name *

Grade

DOB

Gender

Nickname

School:

Primary Address

Address Line 1

City

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?

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

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)

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

Date

Youth Information

Parent/Guardian Information

YOUTH INFORMATION

PARENT/GUARDIAN CONTACT INFORMATION

NON-PARENT/GUARDIAN EMERGENCY CONTACTS

MEDICATION:

MEDICAL CONDITIONS: Please answer in detail if applicable or write N/A. Attach additional pages if necessary.

Church Photo Release Form for Children and Youth

Metropolitan Baptist Church

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