2023-2024 North Pointe Youth Parent Waiver

Please make sure to add each childs name that will be covered under this waiver. If the childs name is not on the waiver, the waiver will be considered invalid.

Your name *

Email address *

Phone number *

Household members

Names of Teens - REQUIRED. You can add more than one
Add another Adult ( Optional)

Address

Preferred Method of Contact *

Email Me

Call Me

Text Me

Parent Waiver & Release of Liability *

I hereby give permission for my child to be photographed and/or filmed without any reimbursement of any kind due to me, or the need to pay any fee. North Pointe Community Church considers all information personal and confidential and will only use it within the church for ministry or other church related activities and will not release it to outside parties or organizations.

In the event of an emergency and medical treatment is required, I give permission to the church staff and/or sponsors to obtain services for treatment as deemed necessary if I cannot be contacted in a reasonable amount of time. Further, I will hold harmless or indemnify North Pointe Community Church for any loss or injury that may be sustained. I recognize that there are risks inherent in activities my child may be engaged in and again I waive, hold harmless, or indemnify North Pointe Community Church, its instructors, paid or volunteer staff, successors, heirs and assigns from any action.

We, the undersigned parent(s) or legal guardian(s) for the students named below, give our permission for our child to participate in offsite events between October 1, 2023 to September 31, 2024.

We also give permission for any representative of North Pointe Community Church to obtain any necessary medical treatment as needed while offsite. We assume responsibility for any medical bills incurred and should our child have to return home before the group for medical or disciplinary reason, we also herby assume any cost incurred. We give authorization for the previously mentioned to provide all necessary food, transportation, and lodging as applicable. We do hereby release, forever discharge and agree to hold harmless, North Pointe Community Church and it's staff and the representatives thereof from any and all liability claims, or demands for personal injury, sickness, or death, as well as property damage and expenses of any nature whatsoever which may be incurred by my child in the course of participation in the aforementioned. Furthermore, we agree to assume all responsibility for any of the previously mentioned occurrences.

****PLEASE NOTE BY TYPING YOUR NAME BELOW, YOU ARE ELECTRONICALLY CERTIFYING THIS WAIVER DOCUMENT JUST AS IF YOU WOULD PHYSICALLY SIGN IT IF IT WAS ON PAPER****

I certify that I am the parent or legal guardian of the above minors and confirm that the information I entered is accurate and true. *

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