Waiver & Medical Release Form 2018/19

YC Alberta 2019 - Next

(Required) If you have more than one child, put their name on the next line
Parent/Legal Guardian's Name *
Parent/Legal Guardian's Name
Parent/Legal Guardian's Phone Number *
Parent/Legal Guardian's Phone Number
Emergency Contact's Name
Emergency Contact's Name
Emergency Number:
Emergency Number:

By clicking "I agree", I agree to give my consent for the person/persons identified above and will assume all liability for their participation in this activity/event and any injury that may result during transport to and from the activity/event.

Your child must be covered by Provincial Health Insurance or equivalent medical insurance.

  • I will not hold Family of Faith Church, its officers, agents, employees, assigns or anyone acting on its behalf, responsible or liable for injury occurring to the named person/persons in the course of such activities or such travel.
    Precautions are taken for the safety and health of your child, but in the event of accident or sickness, Family of Faith Church, its staff, its volunteers are hereby released from any liability.

  • I hereby accept financial responsibility for personal items lost by the person/persons identified herein.

  • I authorize Family of Faith Church to transport and to obtain, through a physician of its own choice, any emergency medical care that may become reasonably necessary for the person in the course of such activities/events or such travel, and agree to accept the cost of transportation and/or treatment by medical personnel or facility.

  • In the event that your child requires special medication, x-rays or treatment, the parents/ guardians will be notified immediately. In case of surgical emergency, I hereby give permissions to the physician selected by Family of Faith Church to hospitalize, secure proper treatment for, and to order injection, anesthesia or surgery for my child as named above.

  • At youth events we take pictures to remember events and share the excitement of youth group with others. We may take pictures of your child and use them on the youth web site or in another form of promotional material (e.g brochure, Facebook, etc.) Unless submitted in writing to the church we will assume this is permissible.

Event Information

  • Date: Saturday, May 18th to Monday, May 20th
  • Location: Enmax Centrium, Red Deer, AB
  • Cost of the Event: $150

Things to Bring

  • Money for snacks, lunch, and merchandise (If you would like to purchase merchandise).
  • Your Bible
  • Personal hygiene items, modest clothing for the weekend,light jacket, water bottle, sleeping bag, pillow and possibly sun screen

Rules and Expectations

  • Come with a positive attitude and a heart open to hear from God.
  • We will clearly communicate a meeting place outside each venue and a time to meet there. We expect everyone to be on time.
  • When we are in the Enmax Centrium during the main sessions, please respectfully remain in your seats, especially while the speaker is speaking. If you need to go to the bathroom, please let an adult chaperone know. If any members of the group are missing, we will come looking. We would prefer everyone to be in their seats, so everyone can take in the sessions.
  • In the afternoons, there are many workshops, concerts and more going on, please stay in groups of at least 2 or 3. Each group must have at least one charged cell phone and are able to be reached at all times. There are lots of options in the afternoons. We encourage you to plan on going to one workshop each day if possible. You are required to attend at least one workshop over the course of the weekend.
  • No one is allowed to leave the grounds at YC unless for special needs and will have to be escorted by a chaperone or parent.
  • Please by courteous and respectful to everyone.
  • If the chaperones observe behavior that is unsafe, or members of our group deliberately not following/respecting the rules, parents will be notified to pick up their youth.
  • Rooms are gender specific. No guys in a girl’s room, no girls in a guy’s room.
  • Have fun, and take this time to deepen your relationship with Jesus.

Youth Leader's Contact Information

Shaelyn: (780)-860-9766
Shaun: (587)-777-2217

We will contact the parents with more information about the event closer to the event.