Parental Authorization, Consent and Release for Children to Attend Church Activities Outside Church Premises

I am the parent or legal guardian of %child_first_name%  %child_last_name% . As the parent or legal guardian, I certify and affirm that I have been completely and thoroughly informed that my child will be attending church activities which will be facilitated by the church officers. For this reason, my child will be participating in certain activities which carry with them a degree of risk and danger.I fully comprehend that this PARENTAL AUTHORIZATION, CONSENT AND RELEASE has the same force and effect even if the activities engaged in are free or if a fee is charged. Further, I will assume on my child’s behalf, whether foreseen or unforeseen, all risks in connection with said activities for any harm, injury or damages that may happen to my child as a result of my child’s participation in these activities, and I still wish to allow my child to proceed with the activities.


Furthermore, on behalf of my child, I hereby voluntarily release, forever discharge, and agree to hold harmless the church and its officers/facilitators from any and all claims, demands, or causes of action, which are in any way connected with my child’s participation in these activities or use of equipment and facilities in connection to these activities.


I understand that I have to inform beforehand the facilitators, all health considerations or medical conditions that would restrict my child’s participation in any and all activities. Also, in cases when medical attention should arise, the church will attempt to contact me as soon as practicable under the circumstances.


In cases of emergency, I further give my consent to the church officers/facilitators so that my child can be examined or treated by a physician duly-licensed to practice medicine in the United States of America or any health care professional duly-licensed to provide health care serviced in the United States of America for medical care and services deemed necessary by the doctor, its agents, servants, and employees. I give permission to the doctor or healthcare professional to provide any and all medical care they deem, in their professional opinion, to be necessary. I agree to pay for any and all medical expenses incurred as a result of the use of this consent.


Finally, I hereby attest that I have fully informed myself to the contents of this PARENTAL AUTHORIZATION, CONSENT AND RELEASE by reading it before I signed it. I also attest that this authorization, consent, and release is willingly executed on my child’s behalf.


Date of Trip:

Start Date:

End  Date:

Number of Days:

Location :


Contact Number in case of an emergency: