Join the Adventure: Youth Group 2024-2025 Registration & Liability Form

Fill out the form below to ensure your child is ready for all the fun, faith, and friendships this year with LifePoint Youth Group!

LifePoint Church Youth Group Liability Release Form

(For the period of September 2024 - August 2025)

Thank you for allowing your child to participate in the LifePoint Church Youth Group. To ensure a safe and enjoyable experience, we require all parents or guardians to complete the following liability form. This form covers all events and activities organized by LifePoint Church Youth Group during the specified period.

Parent/Guardian Information

First Name

Last Name

Phone Number

Youth Information

First Name

Last Name

Birthdate

Gender

Grade

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Emergency Contact Information

First Name

Last Name

Phone Number

Relationship to Youth

Medical Information

Does the youth have any allergies? If yes, please list below

Is the youth taking any medication? If yes, please list below

Does the youth have any medical conditions we should be aware of? If yes, please explain below

Doctor's First Name

Last Name

Doctor's Phone Number

Insurance Company

Policy Number

Acknowledgement and Consent

I, the undersigned parent or legal guardian of [Youth Name], hereby give my permission for him/her to participate in the LifePoint Church Youth Group events and activities for the period of September 2024 to August 2025.
I understand that LifePoint Church will take reasonable steps to ensure the safety of my child, but I acknowledge that there are risks involved in these activities. I agree not to hold LifePoint Church, its leaders, volunteers, or staff responsible for any injury, accident, or harm that may occur during youth group events, trips, or activities.
In the event of a medical emergency, I authorize the leaders of LifePoint Church to seek appropriate medical treatment for my child. I understand that every effort will be made to contact me or my emergency contact before proceeding with treatment.
By signing this form, I confirm that I have read and understood the information provided, and I agree to the terms and conditions stated.

First Name

Last Name

Today's Date

Signature

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