CCO YOUTH WAIVER FORM

One (1) Waiver per every (1) student is required to participate with Calvary Chapel Oceanside Camps/Events/Activities.

Your name *

Email address *

Phone Number *

Household members

Please add the student (ONLY ONE) for whom you are signing this waiver form

Student's School *

Medical Insurance Information

Insurance Policy Name

Insurance Policy Account

Insurance Phone Number

Emergency Contact Information

If Parent/Guardian (filling out this form) cannot be reached

Name of Contact (if Parent/Guardian cannot be reached) *

Contact's Phone Number *

Release of Liability

I hereby give my permission for the above-named student to participate in activities/camps conducted with Calvary Chapel Oceanside. Transportation to events/activities/camps will be provided by private vehicles of the leadership of the CCO Youth Ministry or by Parent/Guardian.
LIABILITY RELEASE: I also hereby release, forever discharge and agree to hold harmless Calvary Chapel Oceanside Church, employees, directors, and youth leaders 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 the undersigned and the above named student that occur during all Student Ministry events and activities.
MEDICAL RELEASE: Should an accident/injury occur, further permissions are also hereby granted to the Youth Leader or Church personnel to authorize any necessary hospitalization or treatment thought by said Youth Leader or Church personnel to be in the best interest of the above-named student. Parent/Guardian hereby assumed the financial responsibility for transportation, hospitalization and medical treatment provided. Should any accident or illness occur during any CCO Youth Ministry events/activities/camps, I will not hold Calvary Chapel Oceanside employees, directors, and youth leaders responsible for medical aid rendered.

Release of Discipline & Illness

DISCIPLINE: I understand that I am responsible for ensuring that my child behaves appropriately during CCO Youth Ministry events/activities/camps. I further understand that, if in the opinion of the Youth Leader or Church personnel, my child is not behaving appropriately, I may be asked to pick-up my child early from the event/activities/camp at my own expense, and that it is at the Youth Leader or Church personnel’s discretion whether or not to refund any fees that I’ve paid for events/activities/camps.
ILLNESS: I understand that my child may not participate in an activity/event/camp if he/she appears to be ill. I further understand that if my child appears to be ill when he/she arrives at the activity/event/camp or becomes ill during the activity/event/camp, I will be asked to pick-up my child early from the activity at my own expense.

Photo & Social Media Release

PHOTO and SOCIAL MEDIA RELEASE: I hereby authorize and give full consent, without limitations or reservations, to Calvary Chapel Oceanside to publish photographs or videos in which the above-named student appear while participating in any program with Calvary Chapel Oceanside. There will no compensation for use of any photographs or videos.

I have read and agree to the above statements

Release of Liability

Release of Discipline & Illness

Photo & Social Media Release

Agreements

I attest that the above-name student is in good physical condition. I have read the above and agree, as the party legally responsible for the above-named student, to all the statements and terms. I further agree not to hold Calvary Chapel Oceanside Church, employees, directors, youth leaders, and volunteer staff liable for damages, losses, diseased or injuries by the minor listed on the form.

Electronic Signature Here (Full Name) *

Today's Date *

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