Child Name *

First Name

Last Name

Child Phone *

If they have one

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Child Birthday *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent Phone *

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Emergency Contact *

First Name

Last Name

Emergency Phone *

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MEDICAL LIABILITY RELEASE FORM I, the parent or legal guardian of hereby authorize NewGen Youth Group, a ministry of Freedom Center Church, to obtain medical treatment for my child in the event of an emergency during any youth events or activities. I acknowledge that I am responsible for all costs associated with any medical treatment my child may receive and that NewGen Youth Group and Freedom Center Church assume no responsibility for any medical expenses incurred. I further acknowledge that NewGen Youth Group and Freedom Center Church have no obligation to provide medical care to my child, but will make every effort to obtain medical treatment as soon as reasonably possible in the event of an emergency. I hereby release and hold harmless NewGen Youth Group, Freedom Center Church, its directors, officers, employees, volunteers, and agents from any and all liability arising from any injury, illness, or other medical condition my child may suffer during any youth events or activities. I further grant permission to NewGen Youth Group and Freedom Center Church to use my child's medical information in the event of an emergency and authorize NewGen Youth Group and Freedom Center Church to disclose my child's medical information to emergency medical personnel as necessary. I hereby warrant that I am the parent or legal guardian of the above-named minor. *

Yes

PHOTO/VIDEO RELEASE FORM FOR MINORS I, the parent or legal guardian of [Insert Child's Name], hereby grant permission to Freedom Center Church and NewGen youth group to use any photographs and/or video recordings taken of my child during church youth group events and activities for use on their website and other promotional materials. I understand that my child's photograph or video may be edited, copied, exhibited, published, or distributed and waive the right to inspect or approve the finished product. I acknowledge that Freedom Center Church and NewGen youth group will own all rights to the photographs and/or video recordings. I release, discharge, and agree to hold harmless Freedom Center Church and NewGen Youth, its directors, officers, employees, volunteers, and agents from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking of said picture or in any subsequent processing thereof, as well as any publication thereof. I hereby warrant that I am the parent or legal guardian of the above-named minor and have the right to contract in my own name and on behalf of my child. I have read the above authorization, release, and agreement, prior to its execution, and I am fully familiar with the contents thereof. *

Yes