Information received is confidential and is being gathered for the purposes of serving your child while in the care of Bethel Pentecostal Church. Any medical information collected here serves to authorize Bethel Pentecostal Church, and its staff and volunteers, to obtain medical assistance in emergencies.
Activity: Bethel Youth
Date: Weekly Jr. High Youth Night at Bethel Pentecostal Church and/or Sr. High Youth at Sundridge Public School September 2024- June 2025
Chaperones: Pastor Curtis Gudrie, Jenn Gudrie, Jody Baillie and Corrie Menzies
The safety of your child is our primary concern. Precautions are taken for the safety and health of your child. In the event that your child requires special medication, x-rays or treatment, the parents/guardians will be notified immediately.
I/we, the parents or guardians named above, authorize Pastor Curtis or one of the Bethel Pentecostal Church Ministry Staff to sign consent for medical treatment and to authorize any physician or hospital to provide medical assessment treatment or procedures for the participant named above.
I/we named above, undertake and agree to indemnify and hold blameless the Pastor, the Ministry Staff, Bethel Pentecostal Church, its Pastors and Church Board from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of the Bethel Pentecostal Church, as well as of any medical treatment authorized by the supervising individuals representing the church. This consent and authorization is effective only when participating in or traveling to events of the Bethel Pentecostal Church. In the event that your child requires special medication, x-rays or treatment, the parents/guardians will be notified immediately.
Bethel Pentecostal Church is collecting and retaining this personal information for the purpose of enrolling your child in our programs, to assign the student to the appropriate classes, to develop and nurture ongoing relationships with you and your child, and to inform you of program updates and upcoming opportunities at our Church. This information will be maintained indefinitely as it is a requirement of our insurance company and legal counsel. If you wish Bethel Pentecostal Church to limit the information collected, or to view your childs information, please contact us.
I, the undersigned, hereby consent to the use of my students photograph or likeness in any publication, videotape, pamphlet or promotion by Bethel Pentecostal Church or other agencies which are promoting or furthering the mission of Bethel Pentecostal Church. I understand that I will not receive separate compensation or consideration from Bethel Pentecostal Church or anyone else for the permission granted in this Consent nor for the actual publication or use of my photograph or likeness. By signing this Consent, I understand I am releasing Bethel Pentecostal Church from any and all liability that may occur as a direct or indirect result of my photograph, the release of my identity, or the public relations materials, including but not limited to the use of any quotations.