By signing this form, I agree:

To give permission for my youth student to attend all events and activities sponsored by or attended by the Park Hill Christian Church Youth Ministry Group (PHCC).

For Park Hill Christian Church to obtain any reasonable medical treatment or emergency medical care as deemed necessary by a licensed physician.  I agree to pay for any treatment or medicines that my child receives.  I designate the adult leaders to dispense any prescription medication my child is required to take or have available while participating with PHCC Youth activities.

I release and agree to hold harmless PHCC and any related agency, church, member, employee, volunteer, or agent, from any liability, injury, damage or loss (including without limitation electronic devices), accidents, delay, or irregularity related to my child’s planned participation or involvement in PHCC sponsored activities.  

PHCC reserves the right to remove and refuse youth participation, at PHCC’s sole discretion, now or in the future for any reason. By signing this statement, I agree my child should be subject to the exercise of this right of removal/refusal as deemed necessary by PHCC and to pay for any costs incurred by the youth being sent home for disciplinary reasons.

PHCC has permission to use my youth’s name, image, video, voice, likeness on the PHCC website, media, or other marketing materials.