Parental Permission Form (Youth)


Acknowledgment Statement 

The undesigned does hereby give permission for our (my) child to attend and participate in the event sponsored by Praise Assembly of God. The undersigned releases Praise Assembly of God or any member from any liability for injury or damage arising from or as a result of participation in any activity. We (I) authorize an adult, in whose care the minor has been entrusted to consent for any X-ray examination, anesthetic, medical, surgical, or dental diagnosis, or treatment and hospital cure, to be rendered to the minor under the general or special supervision and the advice of any physician or dentist licensed under the Medical Practice Act on the medical staff of a licensed hospital. The undersigned shall be liable and agree(s) to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child pursuant to this authorization. Should it be necessary for our (my) child to return home due to medical reasons or otherwise, the undersigned will assume all transportation costs. The undersigned does also hereby give permission for our (my) child to ride in a vehicle designated by the adult in whose care the minor has been entrusted while attending or participating in activities sponsored by Praise Assembly of God. Praise Assembly will not be responsible for any lost or stolend personal items your child brings such as computers, tablets, cell phones, etc.