EVERY NATION YOUTH GROUP WAIVER FORM

I, __________________, the legal guardian of ________________ acknowledge (Parent/Guardian) (Participant) that he/she has my permission to take part in all youth related activities as an informed and completely voluntary act. I understand that he/she will be required to make choices and keep a schedule, and he/she may not be under direct adult supervision at all times. I authorize the Every Nation Youth Leaders and/or its representatives to care for the administration of general first aid for minor injuries and further authorize them to summon any and all professional emergency personnel to attend, transport and treat my child in the event of a life threatening injury. I recognize that the youth leaders and volunteers of Every Nation Youth Group, and Every Nation Church Vancouver are not responsible for any injuries or death that may occur. I agree to assume all risk associated with his/her participation in such events. I agree to release any staff and volunteers of Every Nation Youth Vancouver, and Every Nation Church Vancouver (paid or volunteer) from all claims, suits, costs and actions of any kind, arising from their exercise of power granted by this authorization. In the Province of British Columbia, this _______ day of ______________, 2013. Participant Signature ____________________ Parent/Guardian Signature ___________________
If you are less than 18 years, a Parent or Guardians signature is required.

Health Number ________________ Emergency Contact __________________ Relationship ________________ Phone ________________