Momentum 2022

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Student Information

 
 
 
 
 
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Emergency Contacts

 
 
 
 
 
 
Insurance

 
 
 
 
 
Legal Releases

Activities:
It is my understanding that participating in the programs and recreational and other activities, including special events and field trips of Pataskala Grace Church (PGC) is a privilege. Before my participation in such activities, I acknowledge that certain risks are associated with such activities, including without limitation, physical injury due to activity-related accidents, physical injury due to transportation-related accidents, illness, or even death. In addition, I acknowledge that there may be other risks inherent in these activities of which I may not be presently aware.


COVID -19:
I will comply with all PGC and location-specific rules and policies regarding COVID-19 precautions, as may be amended from time to time. Depending on the location, this may include social distancing, hand washing, having temperature taken, requiring face coverings, and other safety measures.  Despite any safeguards established by PGC or host locations, participation in face-to-face gatherings and using facilities and equipment will always present a risk of contracting the COVID-19 virus. I agree that my child will take personal responsibility for their health and safety while participating at Momentum.


Release of Liability:
Even though it is impossible to identify or be aware of every risk or injury that such activities may involve, by signing this form, I expressly warrant that I am capable of withstanding both the physical and mental demands of such activities I might engage in. I also expressly assume all risks of my participation in the activities, whether such risks are known or unknown to me at this time. I further release PGC and its pastors, ministers, leaders, employees, volunteers, and agents from any claim that my family or I may have against them as a result of injury or illness or any other form of damages or claims I may have related in any way to my participation in such activities. This release of liability shall include, without limitation, any claims of negligence or breach of warranty and is intended to cover all claims from me, my family, or my estate, heirs, representatives, or assigns I may have. I further agree to indemnify, hold harmless and defend PGC, its pastors, ministers, leaders, employees, volunteers, and agents from and against any and all claims or other causes of actions related in any way to my participation in such activities.


First Aid And Emergency Medical Treatment Consent:
I recognize that there may be occasions when I may be in need of first aid or emergency medical treatment as a result of an accident, illness, or other health condition or injury. I do hereby give permission for agents of PGC to seek and secure any needed medical attention or treatment if in the agent's opinion, such need arises. In doing so, I agree to pay all fees and costs arising from this action to obtain medical treatment. I also give permission to physicians, dentists, hospitals, and other health care providers and institutions to administer any needed medical treatment, including surgery, and agree to pay for any such services rendered.



Behavior Contract:
This trip is to be centered around Christ. We expect the youth to enjoy themselves, but it is extremely important to behave appropriately. If at any time we feel that a youth is being disruptive to others or acting out in a way that is inappropriate, we will contact the parent. If the behavior is extreme, the parent may be required to pick up their youth. We cannot have one individual disrupting the possibility of others coming to know Christ or growing closer to Him.


Publicity Consent:
On occasions, PGC takes photographs or makes an audio or videotape recording of children and/or adults involved in church activities. Such photographs or video records may be used by staff and participants to remember the activities and participants. In addition, such photographs and audio/visual recordings may be used in PGC publications or other materials to let others know about its ministries. In addition, local news organizations may hear of our activities or events, and PGC may invite or allow them to photograph or record its events for news reporting on special interest features. I hereby consent to the use of any such audio or visual record of me as PGC sees fit. This consent includes but is not limited to photographs, videotapes, and audio recordings. Furthermore, I give permission to be interviewed by the news media, or for such photographs and other audio or visual records to be used by the news media. 

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Signature of Participant (18+) or Signature of Parent or Guardian of Minor

By typing my full name below I agree to participate in the functions and activities of Pataskala Grace Church, to cooperate with the leaders and other young people while observing the guideline put into place. I promise to respect my leader, other people, property and myself. I understand that my continued participation in Pataskala Grace Church activities depends on my support of this agreement. I hereby represent that I have read all the information in this packet, am fully familiar with the contents therefor, I wish to participate, or allow my minor child to participate, in the activities of all the representations, releases, waivers, consents, promises to indemnify and other information contained herein.

 
Minor Participant Agreement (if applicable)

By typing my full name below I agree to participate in the functions and activities of Pataskala Grace Church, to cooperate with the leaders and other young people while observing the guideline put into place. I promise to respect my leader, other people, property and myself. I understand that my continued participation in Pataskala Grace Church activities depends on my support of this agreement. I hereby represent that I have read all the information in this packet, am fully familiar with the contents therefor, I wish to participate, or allow my minor child to participate, in the activities of all the representations, releases, waivers, consents, promises to indemnify and other information contained herein.

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Description

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