First Presbyterian Church of Winchester

Serving Christ and Neighbor in Winchester and Beyond since 1800

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You are here: Home / Youth Permission and Medical Release Form

Youth Permission and Medical Release Form

Youth Permission and Medical Release Form

I hereby grant permission for my child(ren) to participate in the First Presbyterian Church Youth Ministries. Should any problems arise concerning the behavior of my child that would require them to return home prior to the end of the activity, I will pay for his or her return or arrange for their pick up. I, the undersigned parent or legal guardian, individually and as guardian of the child(ren) listed below, hereby release and discharge First Presbyterian Church, its employees, representatives, agents, servants, activity sponsors, chaperones, drivers (over the age of 18 years old), and any and all assigns thereof from all claims, actions, damages, expenses, and compensation whatsoever which may result from the participation of my child in activities sponsored by the First Presbyterian Church.
Medical Consent(Required)
I authorize the treatment, by a qualified and licensed medical doctor, of the minor listed above in the event of any medical emergency which in the opinion of the attending physician, is necessary and I/we cannot be reached after a reasonable effort has been made to secure my/our personal consent. Any medical expenses are the responsibility of the participant and their insurance carrier.
Consent(Required)
I recognize that First Presbyterian Church uses photographs and video images of events in our publicity materials such as the
church website, social media, newspapers, and newsletters.
There will be times throughout the year where the group may watch movies together. In regards to PG-13 movies:
Social Media and Communication: We believe there is importance in relationships that foster and encourage strong faith development. With this in mind, I give the church's approved adult mentors, staff, and volunteers permission to communicate with my child for the purpose of an invitation to large group events and encouragement via a variety of platforms, including social media, apps, phone, texting, and email.
DigitalSignature

Upcoming Events

Jan 30
January 28 - February 4

FPC Hosting WATTS Jan 28th – Feb 4th

Apr 19
5:30 pm - 7:00 pm

Spaghetti Dinner and Auction benefitting WDS Preschool

Apr 28
April 28 - April 29

Apple Blossom Artisan Craft Fair – FPC Parking Lot

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First Presbyterian Church of Winchester | 116 South Loudoun Street | Winchester, Virginia, USA, 22601

Tele. No.: 540-662-3824 | Fax: 540-662-8498