A Parental/Guardian Consent Form is required to be on file in order for a student to participate in Cross Point Youth Ministry activities and trips. Please complete this form for each student.
Parent/Guardian Information
Insurance & Emergency Contact Information
Parent/Guardian Agreement
By e-signing below, the parent/guardian listed on this form agrees to the following:
The undersigned does hereby give permission for my child, the above mentioned, to attend and participate in youth functions.
I authorize an adult, in whose care the above mentioned minor has been entrusted, to consent to any x‐ray, anesthetic, medical, surgical, or dental diagnosis or treatment, and hospital care to be rendered to the above mentioned minor under the general or special supervision, and on the advice of any physician and/or dentist, licensed under the provisions of the Medical Practice Act, on the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said practitioner or said hospital.
The undersigned shall be liable and agrees to pay all costs and expenses incurred in connections with such medical and/or dental services rendered to the above mentioned minor pursuant to this authorization. Should it be necessary for my child to return home due to medical reasons, or otherwise, the undersigned agrees to pay all transportation costs.
The undersigned does hereby give permission for my child to ride in any vehicle designated by the adult in whose care the above mentioned minor has been entrusted while attending and participating in church activities.
Above listed youth agrees to abide by and obey all rules and policies set forth by the Cross Point Youth Ministry, church, youth pastor, adult counselors, and other leaders. If youth fails to obey rules and policies, parent/guardian agrees to come and transport youth home if deemed necessary by youth pastor or other adult leaders.
A typed name below shall be the equivalent of a signature.