2022-2023 Medical Information & Release

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Salina First United Methodist Church



122 N 8th ST, Salina, KS 67401

785-825-0228

This form covers all Salina First UMC events from August 2021 -July 2021
Please select one option.
First Kids includes all Children's Activities: Mid-Week Manna, Sunday School, Alpha Bells, Kids Choir, Vacation Bible School, First Kids Spcial Events.

@First Youth includes all Youth Activities: Sunday School, Middle SChool MYF, High School MYF, Summer Trips/Activites, volunteer activities.
Participant Information

(To be completed by participant or an authorized guardian)

 
 
 
 
 
Please select one option.
 
 
Please select all that apply.
Please select one option.
 
 
 
 
 
 
 
 
 
 
 
Participation Agreement

By signing below, the participant (or parent/guardian if participant is a minor) acknowledges and accepts the risks of physical injury associated with participation in the activity described above. Except for gross negligence on the part of the sponsor, the participant (or parent/guardian) accepts personal financial responsibility for any bodily or personal injury sustained during the activity. Further, the participant (or parent/guardian) promises to hold harmless the sponsoring organization and its representatives for any injury related to the activity. If dispute over this agreement or claim for damages arises, the participant (or parent/guardian) agrees to resolve the matter through a mutually acceptable arbitration process.

Also, by signing below, parents/guardians give permission for your children/students to be photographed/live-streamed.

By Typing your Full name you agree this Medical Release is correct and authorize Salina First UMC to keep this record for 1 year for use with the Ministry your child is participating in.
 
 

Description

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