ROA Youth ROA Youth Activities Permission Slip & Guidelines Parent/Guardian to complete this section:My childhas permission to attend the activitiesBeing hosted byBaptist Church and Rock of Ages MinistriesStudent Date of BirthAgeGradeSchoolPARENT/GUARDIAN INFORMATIONNameCell PhoneWork PhoneStreet AddressApartment, suite, etcCityState/ProvinceZIP / Postal CodeEMERGENCY CONTACT INFORMATION:Alternate Emergency ContactPhoneRelationshipMEDICAL INFORMATION:All medical information on this form is confidential and is only for the use by church staff, adult sponsors, or medical staff at the event.Is the student currently dealing with any of the following medical conditions?AsthmaSeizuresAllergiesIf yes, listList any prescription medications the student will need at this activity, retreat, camp, or conferenceIn the event it is needed, medical staff or church adult sponsors may administer over the counter medications such as Tylenol, Benadryl, Pepto Bismol, etc.?YesNoSTUDENT GUIDELINES FOR PARTICIPATION:Parents, please read and sign below. Also, please review the Student Guidelines and initial the Student Commitment.I hereby release and hereby agree to hold blameless _______________________Baptist Church, Rock of Ages Ministries and their employees and agents from any and every claim arising, or which may be asserted by me or by any member of my family by reason of participating in any activities associated with __________________________ Baptist Church and Rock of Ages Ministries events. I also release the leaser of the properties on which the event is held. In the event of a medical emergency, if I am unable to be reached by phone, I authorize ___________________________Baptist Church and Rock of Ages Ministries staff, agents, or adult sponsors on this activity to give consent to a physician and or hospital for emergency medical or surgical treatment while on this event. It is understood that I will assume any financial responsibility for any expense that may be incurred for said emergency treatment.Complete the blanks aboveParent/Guardian InitialPhoto/Video waverConsent *I give permission for individual/group photos/video’s including my child/teen to be used in the church’s/ROA publications and media.Parent/Guardian InitialYouth Activities Dress StandardsWe are excited that you are willing to participate in the youth activities at the Rock of Ages Missions Youth Rally! We strive to have a testimony that is above reproach and holds to a traditional and conservative standard. Therefore, we ask respectfully that all participants adhere to the following dress standards and wear modest clothing.Definition of Dress Standard for Young Men:Shirts - No muscle or cut-off shirts; No tight-fitting clothing. Shorts - Not acceptable. Earrings/ body piercing – Not acceptable due to safety concerns. Casual dress, including denim and khakis, are acceptable.Definition of Dress Standard for Young Women:Skirts - Below the knee; no splits. Blouses - No low-cut tops. No tight-fitting clothing. No sleeveless shirts. Dresses - Not required unless otherwise specified. If worn, they must be below the knees; no splits; no low-cut tops. Pants/Shorts -Not acceptable. Casual dress, including denim, and culottes are acceptable for the majority of our activities. For safety reasons, it is required of all participants to wear closed-toed shoes.Middle/High Student SignatureStart signing your signature hereYour browser does not support e-Signature field.Parent/Guardian InitialConsent *I have read the Rock of Ages Ministries Youth Activities Permission Slip and Guidelines for Youth Activities, and I agree to adhere to them as defined by Rock of Ages Ministries.Parents/Guardians NameParents/Guardians SignatureStart signing your signature hereYour browser does not support e-Signature field.DateSubmit
