Parental Waiver: Youth Summer Camp 2024

Child Name *

First

Last

Child Birthday *

Parent Name *

First

Last

Emergency Contact Phone Number *

Medical Details:

Please list any Allergies or Medications (or leave blank)

By signing below I, the undersigned, grant permission for the child listed above to participate in the BCOS Youth 2024 Summer Retreat, on the days of August 15th through August 18th, 2024 (4 days, 3 nights) . In the event of an emergency, I authorize church staff to seek medical treatment for the said child. I am aware of and consent to the activities planned for this trip and grant the church permission to take and use photos/videos of the child. Additionally, I understand and accept the risks associated with these activities and hereby release the church and its representatives from any liabilities that might arise during this trip.

Signature *

Clear Signature

Please sign to confirm agreement.