2024-2025 Youth Parent Guardian Waiver

Gateway City Youth Parent Guardian Waiver

This form serves as the waiver for every event and or youth night at Gateway City Youth (event registration will be seperate). Please make sure to add each childs name that will be covered under this waiver. If the childs name is not on the waiver, the waiver will be considered invalid.

Parent Information

First Name *

Email Address *

Last Name *

Phone Number *

Student Info

First Name *

Date of Birth *

Last Name *

School Grade *

Add a Second Student?

First Name *

Date of Birth *

Last Name *

School Grade *

Add a Third Student?

First Name *

Date of Birth *

Last Name *

School Grade *

Add a Fourth Student?

First Name *

Date of Birth *

Last Name *

School Grade *

Preferred Method of Contact *

Phone

Both

Parent Waiver and Release of Liability

I hereby give permission for my child to be photographed and/or filmed without any reimbursement of any kind due to me, or the need to pay any fee. Gateway City Church and Gateway City Youth considers all information personal and confidential and will only use it within the church for ministry or other church related activities and will not release it to outside parties or organizations.

In the event of an emergency and medical treatment is required, I give permission to the church staff and/or sponsors to obtain services for treatment as deemed necessary if I cannot be contacted in a reasonable amount of time. Further, I will hold harmless or indemnify Gateway City Church and Gateway City Youth for any loss or injury that may be sustained. I recognize that there are risks inherent in activities my child may be engaged in and again I waive, hold harmless, or indemnify Gateway City Church and Gateway City Youth, its instructors, paid or volunteer staff, successors, heirs and assigns from any action.

We, the undersigned parent(s) or legal guardian(s) for the students named below, give our permission for our child to participate in offsite events between September 1, 2024 to August 31, 2025.
We also give permission for any representative of Gateway City Church and Gateway City Youth to obtain any necessary medical treatment as needed while offsite. We assume responsibility for any medical bills incurred and should our child have to return home before the group for medical or disciplinary reason, we also herby assume any cost incurred. We give authorization for the previously mentioned to provide all necessary food, transportation, and lodging as applicable. We do hereby release, forever discharge and agree to hold harmless, Gateway City Church and Gateway City Youth and it's staff and the representatives thereof from any and all liability claims, or demands for personal injury, sickness, or death, as well as property damage and expenses of any nature whatsoever which may be incurred by my child in the course of participation in the aforementioned. Furthermore, we agree to assume all responsibility for any of the previously mentioned occurrences.

We also give permission for our teens to be supported, and connected via Text, Email or Instagram chat for the purpose of communicating information, doing brief check-ins and organizing and planning times for connection in a public place. Communication will be kept if parents/ guardians would like reference.

We also give permission for the opportunity as necessary for offsite community and mentorship following parent consent over text or email.

****PLEASE NOTE BY TYPING YOUR NAME BELOW, YOU ARE ELECTRONICALLY CERTIFYING THIS WAIVER DOCUMENT JUST AS IF YOU WOULD PHYSICALLY SIGN IT IF IT WAS ON PAPER****

Electronic Signature