Dietary & Medical History:
At Youth events, prescription medications for minors must be turned over to adult leaders with clear usage instructions. This means a prescription bottle for that individual with their name, medication, and dosage. If a medication is "As Needed", your minor must understand the symptoms of his/her condition and be capable of asking for help from adult leaders.
A hospital WILL require the participant's social security number, or the Guardian's if the participant is a minor, before treating or admitting the participant. We will contact you should we need this information.
Parental Consent & Liability Release:
As legal guardian of the above-named minor, I hereby give my permission for him/her to be involved with SE Unity Ministries, Inc. Youth Ministries. I am familiar with the general goals and purpose of the SE Unity Ministries, inc. youth program.
I understand I will be notified of any special activities and trips away from church, including location, form of travel, and cost. Should my teen choose to attend such activities, I agree to send him/her with the appropriate clothes, personal items, and money needed. Unless I have made special arrangements with an adult leader, transportation to/from group activities, or to a common drop point for group travel, is my responsibility. or or medical reasons, I agree it will be at my expense.
I hereby grant the church, SE Unity Ministries, inc., and it's representatives, permission to use, without compensation or restriction, photographs and videotaped images (from local, regional and international Unity events) in which the participant appears, in any manner whatsoever, such as but not limited to publication, display, advertising, slide shows, social media, etc.
I understand that health information on this form will be secured and will only be shared, as needed, with adult leaders, church staff and medical professionals to safeguard and support the participant. This information will not be publicly disseminated or released to any outside organization.
I hereby voluntarily and knowingly assume all risks and dangers inherent and incidental to Youth Ministry activities and travel, understanding that some activities may pose a risk of injury. I will not hold liable the church, SE Unity Ministries, inc., their employees, agents, or adult leaders for any injury, illness or property damage involving the above named participant. Whenever deemed necessary by group leaders, I authorize the calling of a doctor and or the providing of other medical services and, unless covered by insurance, agree to pay for said services. If the above named participant is incapacitated or under 18, I do hereby authorize an adult leader as agent for the undersigned to consent with respect to such participant to any x-ray examination, anesthetic, medical, dental, or surgical diagnosis or treatment, or hospital care which is deemed advisable by a state-licensed physician or surgeon.
As parent/guardian of named participant, I hereby attest that I have read this complete document; all information is complete and true; I have legal standing to make decisions which affect the rights of the above named participant; and I understand and consent to all terms outlined in this registration document
