The undersigned does hereby give permission for my child, (Participant), to attend and participate in any Christ the Victor Lutheran Church of Florence, Arizona children/youth ministry activities, events, retreats and childcare during the period of September 1, 2025– August 31, 2026.

LIABILITY RELEASE: In consideration of Christ the Victor Lutheran Church of Florence, Arizona allowing the participant to participate in children/youth ministry (Sunday worship, Sunday meeting, activities, events, retreats, lock-ins, trips) and childcare, I, the undersigned, do hereby release, forever discharge and agree to hold harmless Christ the Victor Lutheran Church of Florence, Arizona, its pastors, directors, employees, volunteers and teachers (collectively herein the “Church”) from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may  be  incurred by the undersigned and the participant while involved in the children/youth activities and childcare. I, the parent or legal guardian of this participant, hereby grant my permission for the participant to participate fully in children/youth ministry activities and child care, including trips away from the church premises. Furthermore, I, on behalf of my minor participant, hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein. The undersigned further hereby agrees to hold harmless and indemnify said Church for any liability sustained by said Church as the result of the negligent, willful or intentional acts of said participant, including expenses incurred attendant thereto.

MEDICAL TREATMENT PERMISSION: I authorize an adult, in whose care the minor has been entrusted, to consent to any emergency x-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment and hospital care, to be rendered to the minor under the general or special supervision and on the advice of any physician or dentist licensed under the provisions of the Medical Practice Act on the medical staff of a licensed hospital or emergency care facility. The undersigned shall be liable and agrees to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child or youth pursuant to this authorization.

EARLY RETURN HOME POLICY: Should it be necessary for my child or youth to return home due to medical reasons, disciplinary action or otherwise, the undersigned shall assume all transportation costs and responsibility.

TRANSPORTATION PERMISSION:  The undersigned does also hereby give permission for my child/youth to ride in any vehicle driven by an approved and licensed ADULT chaperone while attending and participating in activities sponsored by Christ the Victor Lutheran Church of Florence, Arizona. My child/youth and I understand that SEAT BELTS MUST BE WORN AT ALL TIMES during transportation.

NON-NEGOTIABLE RULES

Any participant failing to abide by these rules will be sent home immediately at personal/family expense.

•No use of illicit drugs or alcohol.

•Presence at and full participation in all group activities, including adherence to curfews and other time-related instructions is required.

•No sexual misconduct (defined as exposure, touching, or inappropriate reference to body areas normally covered by undergarments) will be tolerated.

•Participants must be in assigned rooms by designated time.

•Coed visitation is allowed only in assigned community room.

•Smoking and/or the use of tobacco and marijuana products, including vapor-based cigarettes, is not allowed to, from, or during any trip.

•No breaking of any American laws in the United States or any other country is allowed.

GUIDELINES FOR LIVING IN CHRISTIAN COMMUNITY

•Adults and youth will be equally responsible for performing assigned tasks in a timely and cooperative manner.

•Participants will be respectful, encouraging, and will maintain a positive attitude toward others at all times, recognizing Christ’s presence in each other.

•Participants will be respectful of both common living spaces and the property of others.

•Participants will avoid the use of foul language, cursing, or any inappropriate speech (including “humor”) which puts down, makes fun of, or stereotypes other persons or groups.

•Sleeping areas for males and females will be separate.

I agree that Christ the Victor Lutheran Church of Florence, Arizona may photograph and record my child/dependent’s likeness and activities (images) during church-related activities. I grant the following rights to Christ the Victor Lutheran Church of Florence, Arizona: permission to use and re-use, publish and re-publish, and modify or alter the Image(s) taken during the shoot. Use of the Images for editorial, commercial, trade, advertising, and any other purpose may be done in any medium now existing or subsequently developed, on the church website and on the Internet, and worldwide in perpetuity for the purposes stated above.

I waive my right to inspect or approve any editorial text or copy that is used in connection with the Images and release and discharge Christ the Victor Lutheran Church of Florence, Arizona from any and all claims arising out of use of the images for the purposes described above, including any claims for libel, invasion of privacy, or other tortuous act.

I have read the foregoing. I fully understand its contents, understand that this agreement does not expire, and confirm my agreement by signing below. I am over the age of 21 and have legal capacity to sign the release.