HILLCREST STUDENT MINISTRY 2026 Parental Consent

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2026 Medical Release & Permission Form

 
 
 
 
 
 
 
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PARENT/GUARDIAN INFORMATION

 
 
 
 
Additional Emergency Contact(s)

 
INSURANCE INFORMATION

 
 
 
 
MEDICAL CONDITIONS & MEDICATIONS

Please list all medications the student must take.  This includes prescription and essential non-prescription medications.
Include Medication Name, Dose, Treatment for, and Dispensing instructions.
 
 
 
 
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Parental Consent

We ask that you read the following consent with your student.  Your signature as well as their's is required below. 

The undersigned does hereby give permission for my child, named above , to attend and participate in any Hillcrest children/student ministry activities, events, retreats and childcare during the period of January 1, 2026 – December 31, 2026.


LIABILITY RELEASE: In consideration of Hillcrest allowing the Student to participate in student ministry (Sunday worship, Sunday meeting, Activities, Events, Retreats, Lock-Ins, Trips), I, the undersigned, do hereby release and agree to hold harmless Hillcrest, its pastors, directors, employees, volunteers and teachers (collectively herein the “church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Student while involved in the children/student activities and childcare. I, the parent or legal guardian of this Student hereby grant my permission for the Student to participate fully in children/student ministry activities, including trips away from the church premises. Furthermore, I, on behalf of my minor Student, hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein.


PHOTOGRAPHY


The undersigned grant permission to Hillcrest Baptist Church representatives to take and use: photographs and/or digital images of the above named child for use in news releases and/or promotional materials as follows: printed publications or materials, electronic publications, flyers, posters, church promotional slides, or websites. I agree that my child’s name and identity may be revealed in descriptive text or commentary in connection with the image(s). The undersigned authorize the use of these images without compensation. All negatives, prints, and digital reproductions shall be the property of Hillcrest Baptist Church.


 


MEDICAL TREATMENT PERMISSION: I authorize an adult, in whose care the minor has been entrusted, to consent to any emergency x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care, to be rendered to the minor under the general or special supervision and on the advice of any physician or dentist licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital or emergency care facility. The undersigned shall be liable and agrees to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child or student pursuant to this authorization.


 


EARLY RETURN HOME POLICY: Should it be necessary for my child or student to return home due to disciplinary action or otherwise, the undersigned shall assume all transportation costs and responsibility.


 


TRANSPORTATION PERMISSION: The undersigned does also hereby give permission for my child/student to ride in any vehicle driven by an approved and licensed ADULT chaperone while attending and participating in activities sponsored by Hillcrest. My child/student and I understand that SEAT BELTS MUST BE WORN AT ALL TIMES during transportation.


 

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Description

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