EMERGENCY CONTACT DETAILS
In the event of an emergency, please provide the contact details
Youth Leaders for 24/25 School Year
Pastor Fernando Chicas
Pastor Belén Chicas
Tina Wall
Fun Nights (Includes teaching)
Location: Leamington Christian Centre
Times: Wednesday Nights
Super Nights
Location: Leamington Christian Centre
Time: Wednesday Nights
Other events outside the church premises will be notified at lease one week before the event date, and permission forms will be provided.
Photo/Video Release
I hereby grant to Leamington Christian Centre (LCC) the right to reproduce, use, exhibit, display, broadcast, distribute and create derivative works of the photographed images of my youth(s), taken for use in connection with the activities of LCC or for promoting, publicizing, or explaining LCC or its activities. This grant includes, without limitation, the right to publish such images on LCC websites, Social Media sites, in our reports and publications and PR/promotional materials, and any other church-related publication. These images may appear in any of the wide variety of formats and media now available to LCC and that may be available in the future, including but not limited to print, broadcast, videotape, and electronic/online media.
Liability Release and Informed Consent
I hereby give permission to my youth to participate in the activities listed above and authorize the adult leaders supervising these activities to administer emergency treatment to my youth for any accident or illness and to act in my stead in approving necessary medical care. This authorization shall cover all activities, including travel to and from such, should they be necessary and/or provided. I understand that all reasonable safety precautions will be taken by the leaders of these activities and that these activities involve an element of risk that may result from participation by my youth. Transportation injuries may involve injuries from slips or falls when entering or exiting a vehicle, injuries from ignoring safety rules and injuries or death from a traffic accident. I agree to release Leamington Christian Centre Inc., its representatives from liability for damages, losses, diseases, injuries, or death incurred by the youth listed on this form.
Agreement of Conduct
I hereby agree that my youth(s) will participate in activities with other youth(s) and understand that full participation is required to experience healthy and wholesome activities. I agree to instruct my youth(s) to add to that healthy and wholesome experience by refraining from talking about activities, preferences or choices done outside of the program that are not in line with the goals and values of Arise Youth. I also agree to instruct my youth(s) to respect and be cordial to the leaders and other participants and that the leaders may teach, correct and if needed, contact me to pick up my youth(s) if not displaying respectful behavior. The leaders reserve the right to make the decision based on the situation. Parents agree to help their youth be mindful of modest dress for all activities (revealing clothing such as crop tops, short shorts and tight fitting that exploit a youth’s body and features or are revealing in nature are not allowed).
I hereby give permission to my youth to participate in the activities listed above. By digitally signing this form, I agree to all activities, giving informed consent to them, and have read and agree to the Photo and Video release, liability release & Informed Consent, and Agreement of Conduct my youth is to follow.
Please note the information on this form is for the use of the youth leaders at Leamington Christian Centre Inc. and is not available to any other individuals or groups. We will not disclose your e-mail address, cell, or any other details without your permission.
