High Risk Activity Waiver

Student Name *

First Name

Last Name

Student Name 2

First Name

Last Name

Student Name 3

First Name

Last Name

Student Name 4

First Name

Last Name

Parent Name

First Name

Last Name

Phone *

(###)

###

####

General Parent Consent Form *

I have filled out the Parent Consent form for Calvary Youth for 2020-2021. I understand this form provides youth leaders with vital information to aid them in keeping my youth(s) safe.

Yes

No

High Risk Activity Parent Consent *

I hereby consent to the participation of my/our child(ren) in this supervised activity. While every precaution is taken for the safety and good health, some sports and activities carry with them the inherent risk of personal injury beyond the risks associated with many of the recreational activities at Calvary Baptist Church & Calvary Baptist Youth. I/we understand and accept these risks and agree that by allowing my child to participate in those activities, he/she may be taking part in a recreational activity that presents the potential for personal injury. I/we, the parents or guardians named below, authorize the Director or one of the Calvary Baptist Church Personnel to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above in the event a parent or guardian cannot be reached immediately. I/we, named below, undertake and agree to indemnify and hold blameless the Williamson Family, Calvary Baptist Church, Calvary Baptist Youth, its personnel, its Directors and Board from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of the Calvary Baptist Church & Calvary Baptist Youth, as well as of any medical treatment authorized by the supervising individuals representing Calvary Baptist Church & Calvary Youth. This consent and authorization is effective only when participating in or traveling to events of Calvary Baptist Youth. I have read, understood and agree with above.

Yes

No