Forms

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Financial Relief Request for Non-members

Incident Reporting: Tracking Form

Financial Relief Request

for Non-Members

Incident Reporting:

Tracking Form

Financial Relief Request

for Non-Members

Member Building and

Policy Form

Financial Relief Request for Non-members

Non-Member Building

and Policy Form

Reimbursement Form 2020

Annual Youth Permission Slip Form

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Parent's First & Last Name

Parent's Email

Parent's Phone

(above) am the parent and/or the lawful guardian of (below) who are minors.

I understand that the GEMS, Cadets, Junior High Youth Group, High School Youth Group are organizations of Sunnyside Christian Reformed Church.

As Parent, I hereby give my Permission for my Child(ren) to participate in the events and all related activities during 2020. I also, hereby give Authority to the adult leaders of the Organization and any other employees, servants and agents of Sunnyside Christian Reformed Church (“SCRC Agents”) to consent, in my place and with the same authority as I have, to any medical treatment that may be required by Child in connection with the event.

Select an option

Yes

Sunnyside CRC youth groups offer several off-campus events throughout the year. Do you give your child(ren) permission to attend off-campus events?

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Yes

In consideration of the services performed by SCRC Agents, I hereby Release Sunnyside Christian Reformed Church and all SCRC Agents from any and all liability for any damage, injury or loss arising out of actions taken in good faith in connection with the Event, regardless of whether caused by the negligence of any party hereby released.

Select an option

Yes

List any medications, allergies, past medical history, or any activity or dietary restrictions we need to know about, including any RECENT injuries, illnesses, or other medical conditions that may cause additional and/or new injury when participating in any event?

CONSENT FOR EMERGENCY TREATMENT: In case of emergency, I hereby give permission to the physician selected by Sunnyside Christian Reformed Church leaders to hospitalize, secure proper treatment for and order injection, anesthesia, or surgery, for my child/ward as named above. In the event medical treatment is necessary, as stated, I give permission for my child to participate in all activities. If any changes occur, I will contact Sunnyside Christian Reformed Church at the above address. I, therefore, agree to assume as an explicit condition of my child’s/ward’s participation, any and all risks. I agree to hold harmless Sunnyside Christian Reformed Church, its personnel, or other individual transporting my child from any and all liability, claims, damages, and expenses that may arise due to participation of my child/ward in any activities of the above organization. I understand it is my responsibility to inform Sunnyside Christian Reformed Church leaders of my child’s/ward’s change in any medical history that may cause additional and/or new injury when participating in any and all events.

Select an option

Yes

2nd Emergency Phone #

If you have any concerns or queries regarding this form please contact the church office through phone: 509.837.5371 or email:

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