Anyone participating in a youth trip/event/activity/program, whether student under the age of 18 or adult sponsor 18+ needs to fill out the form below in order to participate in the trip/event/activity/program.

Consent/Release Form for Student Events

Staff and Parent/Guardian CONSENT/RELEASE OF ALL CLAIMS & MEDICAL INFORMATION FORM Regarding ALL GI Free Church Youth Trips/Activities/Programs/Events.
  • If you are an adult sponsor that will be going on the trip/activity/program/event, please enter your name in this section also.
  • I do hereby allow this above named student to attend any and/or all youth group activities that I deem appropriate.

    I understand that my/my child's participation in any trip/activity/program/event indicates my decision to allow his/her involvement therein. I agree and consent to have the staff members, leaders and/or counselors, under whose auspices the program is conducted, and any other worker in the program approved as parent to secure any emergency medical care or treatment that may be necessary for me/my child during any/all trips/activities/programs/events, including transportation to and from any and all destinations. I further assume all responsibility for the decisions so made, and the emergency care or treatment so secured by and/or for me/my child as well as the responsibility of any and all medical costs incurred. I do for myself, or on behalf of my child, hereby release, forever discharge and agree to hold harmless Grand Island Evangelical Free Church (GI Free) and the directors thereof, from any 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 the undersigned and/or the child and/or that may occur while I am/said child is participating in any youth group activity. Furthermore I/on behalf of my child hereby assume all risk of personal injury, sickness, death, or damage as a result of participation in any activities involved therein. The undersigned further here agree to indemnify said church, its directors, employees and agents, for any liability sustained by said church as the result of the negligent, willful or intentional acts of said participant. I permit the staff members, leaders, and/or sponsors who lead the trips/activities/programs/events to appropriately discipline myself/my child should the need arise. Should I/my child respond inappropriately or fail to change my/his/her attitude and/or behavior in a positive way, I permit those in charge to send myself/my child home. I understand that I, or my emergency contact, will be contacted before any final decision is made. Should it be necessary for the participant to return home due to disciplinary action, medical needs or otherwise, I hereby assume all transportation costs.
  • Please list the name of someone we can contact in case of an emergency if we aren't able to reach you.
  • If you do not have insurance, please write in "None."
  • If you do not have insurance, please write in "None."
  • I (staff/student) listed above agree to follow all guidelines established by the church staff and volunteers. In the event that I do not, I understand that I may be sent home at the expense of myself/my parent(s)/guardian(s).

  • If the calendar does not pop up, please enter your birth date in the following format: xx/xx/xxxx
  • If the calendar does not pop up, please enter the date in the following format: xx/xx/xxxx