Fill and Sign the Youth Group Form

Release of Claims for Future Accidental Injuries or Death by Parent or Guardian of Minor Child Regarding a Church Youth Group Ski Outing The undersigned John Doe does hereby confirm and agree that my son, Bill Doe , has permission to attend the Acme Church Ski Outing at Widget Ski Resort and will be responsible for his own equipment. In case of sickness or accident, the adults in charge of the Ski Outing have my permission to secure medical treatment for my said Son. Health Insurance Company: (supply name of health insurance company) Policy Number: _____________________ I understand that if medical intervention is needed every attempt will be made to contact the following person(s) immediately: Name of parent or guardian: ________________________________________________ Address: ________________________________________________________________ Phone number of Parent or Guardian: _________________________________________ Name of alternate contact, if parent or guardian cannot be reached: _____________________________________________________________________________ Address: (address of alternate contact) Phone number: ( phone number of alternate contact) Child's medical considerations and medications: _____________________________________________________________________________________ _____________________________________________________________________________________ ________________________________________________________________ I recognize that skiing is an inherently dangerous activity and I assume all risk undertaken by my child in attending this outing. I release Acme Church and all if its staff, volunteers and advisors from any and all claims, loss, cost, damage or expense arising out of or from any accident or other occurrence that causes injury to any person or property, during this outing. Witness my signature this the _____ day of ___________ 20___. ______________________________ JOHN DOE, Parent of Bill Doe