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Consent & Liability Release Form


LIABILITY RELEASE: In consideration of Revive City Church allowing the Participant to participate in youth ministry events, we (I), the undersigned, do hereby release, forever discharge and agree to hold harmless Revive City Church, its directors, employees, volunteers and agents (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in the youth ministry events. We (I) the parent(s) or legal guardian(s) of this Participant hereby grant our (my) permission for the Participant to participate fully in youth ministry events, including trips away from the church premises.  
Furthermore, we (I) [and on behalf of our (my) minor Participant(s)] hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved with youth ministry events therein.  
Further, authorization and permission is hereby given to said Church to furnish any necessary transportation (within the limitations of church insurance and the law), food and lodging for this Participant. The undersigned further hereby agree to hold harmless and indemnify said Church for any liability sustained by said Church as the result of the negligent, willful or intentional acts of said Participant, including expenses incurred attendant thereto.  
 
EARLY RETURN HOME POLICY: Should it be necessary for our (my) child or youth to return home due to medical reasons, disciplinary action or otherwise, the undersigned shall assume all transportation costs and responsibility.  
 
TRANSPORTATION PERMISSION: The undersigned does also hereby give permission for our (my) youth to ride in any vehicle driven by an approved ADULT chaperone while attending and participating in youth ministry events sponsored by Revive City Church. My child/youth and I understand that SEAT BELTS SHALL BE WORN AT ALL TIMES during transportation and are responsible for compliance.  
 
PHOTO RELEASE: The undersigned additionally gives permission for the church to publish photographs or video of my youth on the church website, church social media and in the church newsletter.

MEDICAL TREATMENT PERMISSION: We (I) authorize an adult, in whose care the minor has been entrusted, to consent to any emergency x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care, to be rendered to the minor under the general or special supervision and on the advice of any physician or dentist licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital or emergency care facility. The undersigned shall be liable and agree(s) to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child or youth pursuant to this authorization.
Youth Code of Conduct
 
As a participant in Youth Ministry activities, I agree that, during my participation in, or attendance at, Youth Ministry events, mission trips or other activities that I am responsible for my actions.  
 
Recognize that everyone in the group is a part of the body of Christ. I will embrace inclusiveness by making sure that everyone feels welcome and important.  
Respect the physical and emotional well-being of others by “doing unto them as I would have them do unto me.” (This includes refraining from harsh play or violence, refraining from harmful jokes, respecting the need for personal space, etc.)  
Respect the health of my own body by refraining from the use of tobacco, alcohol, and illegal drugs. I understand that the use of these substances is absolutely prohibited.  
Respect the things I use and the property of places I visit. The areas used for all events, including transportation, shall be left clean.  
Participate fully in all scheduled group activities and abide by additional group guidelines at any youth events.  
Avoid inappropriate public displays of affection.  
Follow all instructions given by group leaders and chaperones without protest. (An instruction may be politely and discretely questioned if it seems unreasonable).  
Stay within the group or assigned sub-group at all times. I will not wander off alone or leave the activity site unless granted permission by an adult, and I will report for all designated check-in times.  
Hold safety in the highest regard and refrain from compromising my own safety or another’s safety.  
Provide a trusting environment for my peers. When others share something about themselves in a group discussion, I will not repeat that information to other friends outside of the group.