General Permission Slip Form

Please fill out 1 form per child.

Your name *

Last name

Email address *

Phone number *

Phone type

Address *

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

Relationship *

Guardian 2 Name

Relationship

Phone number

Phone type

I give permission for my child to be contacted in a group chat with multiple leaders and students via text or instant messenger *

Yes

I give permission for my child to be contacted in a group chat with multiple leaders *

Yes

I give permission for my child to be contacted in a private message by leaders or Pastors *

Yes

I give permission for my child to: *

Drive with 2 leaders and other students

Drive with 2 leaders without students

Drive with 1 leader and other students

Do not give permission for a leader to drive my student

Student Information

Full Name *

Cell Number

Birthdate *

Grade *

Gender

Alberta Health Care Number *

Youth Code of Conduct *

As a youth participant in any activity or event that Edmonton Faith Nation holds I understand that I am not to bring any type of drugs, alcohol or have any unacceptable behaviour. I am aware that I will be sent home immediately, the Senior Pastors will be notified of the situation, and my parents will be called.

WAIVER & RELEASE *

I consent to my teenager in their participation in the event.

I understand that supervision will be provided by staff and volunteers of Edmonton Faith Nation Church. I understand there are risks involved in participation in the event and I release Edmonton Faith Nation Center, its staff, volunteers, and partners from any liability for injuries or other damages related to my child's/children's participation.

I understand other participants may record photos and videos of the event and share on their social media and the church has limited control over what is shared by participants on social media.

If the participant's phone number(s) and/or email provided, their leaders may use these to contact them for scheduling and connecting. Other forms of documentable electronic communication may also be used. Unless permission is revoked in writing too the church, we will assume this is permissible.

In the event of an emergency and medical treatment is required, I give permission to the staff and/or volunteers to obtain services for treatment as deemed necessary if I cannot be contacted in a reasonable amount of time.

I recognize that there are risks associated with activities that my child may participate in. I waive, hold harmless, indemnify Edmonton Faith Nation, its staff, volunteers, board, and representatives thereof from any action. I do herby release, forever discharge, and agree to hold harmless, Edmonton Faith Nation and the representatives thereof 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. I agree to assume all responsibility for any of the previous mentioned occurrences, *Edmonton Faith Nation Centre operating as Edmonton Faith Nation

Guardian Signature *

Please sign here to agree to the waiver as describe above

Date Signed *

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Edmonton Faith Nation Centre
info@faith-nation.org
780.450.2132