Activity: Youth Centre Renovations
Date of Activity: June 10 – August 31, 2019
Details of the Activity: We are renovating the youth centre at Beulah Alliance Church West Campus between June 10 & August 31, 2019. We invite students to help as they are available but with pre-arranged times. Students will be assisting with demolition which includes using basic construction tools, ladders and physically hauling construction waste out of the building. We will ensure that there are two ministry personnel for every 16 students.
We are planning an activity as part of our programming that requires your permission prior to participation. We have provided you the details of the activity and request that you complete and sign the permission form. The safety of your child is our primary concern. Precautions will be taken for their wellbeing and protection.
Permission Form and Consent:
Student's Date of Birth
Parent's Phone Number
Parent's Work Phone Number
Student's Health Card Number
Student's Family Doctor
Student's Family Doctor Phone Number
In case of an emergency, contact:
I hereby consent to the participation of my/our child(ren) in this supervised activity.
While every precaution is taken for the safety and good health, some sports and activities carry with them the inherent risk of personal injury beyond the risks associated with many of the recreational activities at (organization). I/we understand and accept these risks and agree that by allowing my child to participate in those activities, he/she may be taking part in an activity that presents the potential for personal injury.
I/we, the parents or guardians named below, authorize the Director or one of Beulah Alliance Church Personnel to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above.
I/we, named below, undertake and agree to indemnify and hold blameless Beulah Alliance Church, its personnel, its Directors and Board from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Beulah Alliance Church as well as of any medical treatment authorized by the supervising individuals representing Beulah Alliance Church This consent and authorization is effective only when participating in or traveling to events Beulah Alliance Church.
I have read, understood and agree with above.
Parent / Guardian Signature:
Parent / Guardian's Name who signed