Staff - Isaiahs Hub

Senior Staff Position

Media Team

Volunteer

PARENT/GUARDIAN PERMISSION FORM FOR YOUTH PARTICIPANT

Both sides of this form must be completed by all youth participating in overnight activities, field trips, events requiring group transportation, and any other events hosted at Isaiahs Hub, where it is deemed necessary by the event coordinator(s). The form should be submitted prior to the event. The form has five parts: (1) information about the participant and activity, (2) parental permission and liability release, (3) medical emergency authorization and health information, (4) pick-up authorization, (5) code of conduct.. Be sure to complete all sections and sign where requested!

Name of Youth Participant

Telephone

Address

City

State

Zip

Birthdate

Grade

Age

Name of Activity/Event

Name of Group Sponsoring Event

Location of Event

Date(s) of Event:

Time of Event

Parental Permission and Release of Liability

I hereby give my son/daughter (named above) permission to participate in the event listed. Although the event coordinator(s) will use the utmost precaution in guarding the health of the above participant and preventing accidents, I release them from any liability in case of illness or injury as a result of this activity.

Sign Out Regulations

I confirm that youth attending the summer program must not leave ISAIAHS HUB before the end of the day (3:00 pm) without an authorized parent or guardian present.

Constent

I confirm that I have fully informed myself of the contents of this Parental Consent, Release Form and Personal Injury Waiver by reading it before I signed it. I warrant that I possess all the rights, powers, and privileges of a parent or legal guardian necessary to execute this document with binding legal effect.

First Name

Last Name

Signature

Senior Staff Position

Media Team

Volunteer

PARENT/GUARDIAN PERMISSION FORM FOR YOUTH PARTICIPANT

Coming Soon!