Copy of PGC Parent/Guardian Medical Release and Consent to Participate 2024-2025

Please fill out this form and click submit.
 
 
 
 
 
 
 
Please select all that apply.
Consent to Participate & Travel

I hereby give my consent for the above student to participate in activities sponsored by Peninsula Grace Church. I also give my consent for the above named student to travel with the group to activities taking place off of church grounds or public lands.
 
 
Liability Release

IT IS THE INTENTION OF (PARENT OR GUARDIAN OF MINOR) BY THIS AGREEMENT TO EXEMPT AND RELIEVE PENINSULA GRACE CHURCH AND ITS OFFICERS, AGENTS, SERVANTS, OR EMPLOYEES FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE, OR WRONGFUL DEATH OF STUDENT CAUSED BY PARTICIPATION IN ACTIVITES SPONSORED BY PENINSULA GRACE CHURCH AND ITS OFFICERS, AGENTS, SERVANTS, OR EMPLOYEES.
 
 
Consent for Emergency Medical Treatment

In consideration of the above named student's opportunity to participate in Peninsula Grace Church activities, I hereby give my consent to emergency medical treatment, hospitalization or other medical treatment as may be necessary for the welfare of the above named student, by a physician, qualified nurse, or hospital in the event of illness or injury during all periods of time in which the student is away from his/her legal residence as a member of a Peninsula Grace Church activity. 
 
 
 
 
 
 
 
Student Participation Agreement

I, the participant, understand that I am under the authority of those officers, agents, servants and employees of Peninsula Grace Church and in no way hold Peninsula Grace Church responsible for any claims of liability while participating in youth activities that could result in personal injury or property damage sustained during youth activities. I have read and discussed these guidelines with my parents/guardians.
 
 

Description

Please fill out this form and click submit.