Hillcrest Youth Participation Agreement

Please fill out one form for each student.
Hillcrest Youth typically meets on Sunday evenings September - April at Hillcrest in the Hill and the Loft for worship, devotions, games, hang-out time, fun activities, and a meal or snacks.  We also plan other activities, mission trips, and service projects throughout the year.

To allow us to best prepare for and serve your student, please fill out the information as completely as you are able.
Student Information

 
 
 
 
 
 
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Please select one option.
 
 
 
 
 
Parent/Guardian Information

 
 
 
 
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Emergency Contact (other than parent/guardian)

 
 
Insurance and Care

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Please select one option.
If yes, please fill in name of medical insurer and policy or group number below.
 
 
 
 
 
Participation Agreement and Photo Release

I acknowledge that participation in the activity described above involves risk to the Participant (and to Participant’s parents or guardians, if Participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness (including transmission of viruses like COVID-19), bodily injury, death, emotional injury, personal injury, property damage and financial damage. 


In consideration for the opportunity to participate in the activity described above (the “Activity”), the Participant (or parent/guardian in Participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the Activity. The Participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the Activity or during transportation to and from the activity as well as for any medical treatment rendered to the Participant that is authorized by the Sponsor or its agents, employees, volunteers, or any other representatives (collectively referred to hereinafter as the “Activity Sponsor”). Further, the Participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the Activity Sponsor for any injury arising direction or indirectly out of the described Activity or transportation to and from the Activity, whether such injury arises out of the negligence of the Activity Sponsor, the Participant, or otherwise. 


If a dispute over this agreement or any claim for damages arises, the Participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable alternative dispute resolution process. If the Participant (or parent/guardian) and the Activity Sponsor cannot agree upon such a process, the dispute will be submitted to a three-member arbitration panel for resolution pursuant to the rules of the American Arbitration Association.
Please select all that apply.
Please select all that apply.
I give permission for photo and video of my child(ren), which may be taken during any ministry activity, to be used for publication purposes and/or appear on the church website, social media, or other in-house publicity.
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Description

Please fill out one form for each student.