Youth Group Contact Information Form

First Baptist Church of Erwin offers to its members, guests, and community, a variety of opportunities to participate in Youth Ministry. These activities may include field trips, recreation, service projects, etc. When working with youth, permission is needed for your child to participate in our programs and activities and we often require parents/guardians to complete and sign several forms for each event. In an effort to save time, repetition and paperwork, we ask that you complete the following online form generated through Breeze, our church information system, about emergency contacts, medical concerns, and health insurance. This form should allow us to gather the needed information with only your signature needed to verify that the information is current to give your consent for participation in all of our events.

Child's Information

Name

Date of Birth

Age as of August 1, 2022

Grade for the 2022-2023 School Year

Medical Concerns: Please list an medical concerns/allergies/dietary restrictions relevant to participation (foods, insects, etc).

Medication: Please list any medications that your child may need to take that we should know about. Include information about administration for the medication.

Miscellaneous Requests or Needs

Parent/Guardian Contact Infomation

Home Address

Home Phone

Parent/ Legal Guardian 1

Parent/Legal Guardian 1 Mobile Phone Number

Parent/ Legal Guardian 1 Email

This address will receive a confirmation email

Parent/ Legal Guardian 2

Parent/Legal Guardian 2 Mobile Phone Number

Parent/Legal Guardian 2 Email address

This address will receive a confirmation email

Alternate Emergency Contact (In the event a parent/Guardian can not be reached)

Alternate Emergency Contact Phone Number

Alternate Emergency Contact's Relationship to Child

Permissions and Agreements

Youth Group at First Baptist Church of Erwin may include Bible Studies, Music, Games, Service Projects, Exploration Activities, and Recreation/Games. Games may take place outdoor or indoors, weather permitting. Occasionally, Youth Group may involve off-campus transportation. There will be separate permission forms generated for these events which will require a parent signature.

Permission to publish the image or likeness of a minor

I give my permission to First Baptist Church of Erwin to publish or post the image or likeness of my child. I do not give my permission to First Baptist Church of Erwin to publish or post the image or likeness of my child

Permission to publish/post the creative product of minors

I give permission to the First Baptist Church of Erwin to publish/ post my minor child’s original/creative work products on the church website, church newsletter, social media pages, church bulletin board, other church publications, local newspaper. I do not give permission to the First Baptist Church of Erwin to publish/ post my minor child’s original/creative work products on the church website, church newsletter, social media pages, church bulletin board, other church publications, local newspaper

Electronic Signature: I acknowledge that by typing my full name in this space provided, that it will be recorded as a timestamped signature once it is submitted. This also serves to confirm that I am a legal parent or guardian of the minor child registered on this form and I agree to the above permissions that I have selected.

Youth Group Contact Information Form

Description

Please Fix the Following