Liability Release and Child/Parent Covenant Form 2025-26

Citylife Children and Youth Ministry

Please submit a form for each child/student.

Student Information

Parent/Guardian Information

The undersigned hereby give(s) permission for the above-named student (“Participant”) to attend and participate in Citylife Children’s Ministry and Youth Ministry activities, events, and outings during 2025-2026. Church sponsored events including but not limited to: 

Please check each section to indicate you have read and agree with the authorization:

In consideration of Citylife allowing the Participant to participate in Citylife Children and Youth Ministries activities, we (I), the undersigned, do hereby release, forever discharge and agree to hold harmless Citylife, 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 activities. We (I), the parent(s) or legal guardian(s) of this Participant, hereby grant our (my) permission for the Participant to participate fully in Citylife Children and Youth Ministries’ activities, 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 therein. Authorization and permission is hereby given to the Church to furnish any necessary transportation (within the limitations of church insurance and the law), food, and lodging for the Participant. The undersigned agree(s) to hold harmless and indemnify the Church for any liability sustained by the Church as a result of negligent, willful, or intentional acts of Participant, including expenses incurred attendant thereto.

We (I) authorize an adult, in whose care the minor Participant 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 Participant 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 minor Participant pursuant to this authorization.

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.

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 activities sponsored by the Church. My child and I understand that SEAT BELTS SHALL BE WORN AT ALL TIMES during transportation.

Ministries are released to use my child's image for promotional purposes such as brochures, videos, web pages, social media etc.

*Please review this section with your child/teenager:

Recognize that everyone in the group is a part of the body of Christ. I will help everyone feel welcome and valued.

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 sleep, etc.

Respect the health of my own body by refraining from the use of tobacco, alcohol, illegal drugs and weapons. I understand that the use of these substances is absolutely prohibited. They will be confiscated and parents and/or authorities contacted immediately.

Respect the things I use and the property of the places I visit. The areas used for all events, including transportation, shall be left clean.

Act appropriately and respectfully. No public displays of affection.

Follow all instructions given by leaders/chaperones. An instruction may be politely questioned.

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 outside of the group.

Take the initiative to inform my guests of their responsibility to follow these guidelines when they visit or participate in an event.

Consequences will focus on restoring peace with reconciliation among the parties involved. The goal of resolving each problem will be growth and learning through repentance and forgiveness. Any problems encountered will be handled within the group and by the adult leaders to the extent that this is possible. However, should a situation persist or become uncontrollable, the parent/guardian will be contacted and informed of the problem. Should the situation be urgent, the parent/guardian will be contacted immediately and will be responsible for picking up the minor Participant from an event or providing for his/her transportation home.

I am committed to supporting our Family Ministry by serving in one of the following ways:

Medical Information

Student/Participant and Parent/Guardian Agreement

By selecting 'I agree' and submitting this Annual Permission / Consent / Liability Release and Student Covenant Form I am acknowledging that I have read and understand these guidelines. I recognize that this is a permission slip, medical release, liability release, and covenant for 2025-26. I commit to abide by the provisions of this Release Form and recognize that participation may be restricted or denied without this signed and completed form.

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