Authorization and Medical Form
MEDICAL INFORMATION
The information received is confidential and is being gathered for the purpose of serving your child while in the care of YFC staff and volunteers during the National Ministry Conference (NMC). Any medical information collected here serves to authorize YFC and its staff and volunteers to obtain medical assistance in emergencies.
PHOTO/VIDEO CONSENT
As parent/guardian, I agree to permit reasonable use of photos, videos, written materials or other pictures of my child/youth during the child/youth programming provided during NMC, understanding that they could be used by YFC Canada in the promotion of future YFC activities and programs. I understand that these could appear in agency newsletters, brochures, website or social media; or in local newspapers, on television, and might identify participants by first name.
PERMISSION TO PARTICIPATE/WAIVER
By checking the corresponding box, I give permission for the indicated youth/child in my care to participate in the event set forth by YFC and any of its subsidiary programs. Furthermore I do not hold YFC or any of its subsidiary programs responsible for any harm that may occur to the above named youth/child on this form as a result of his/her willful participation in the event.
ACKNOWLEDGEMENT/RELEASE
I undertake and agree to indemnify and hold harmless Youth for Christ/Youth Unlimited, Program Personnel, YFC Canada, its trustees, directors, corporation members, servants, agents, volunteers, employees and all program personnel from any and all actions, causes of actions, claims and demands whatsoever whether existing as of this date or in the future; and, against any loss, damage or injury suffered by my youth/child as a result of being part of the activities of NMC, as well as of any medical treatment authorized by the supervising individuals representing YFC Canada. This consent and authorization is effective only when participating in events sponsored by YFC Canada.
In the event of an emergency, I authorize the administration of any first aid treatment necessary, and in the case of medical emergency, give permission to the Physician selected by the supervisors to hospitalize and secure proper treatment for my youth/child. Every effort will be made to contact parents or guardians before such action.
I acknowledge that it is my responsibility to take the necessary steps for insuring against personal injury, property damage, or any loss by my youth/child or by self. I also acknowledge that I must assume total responsibility for ALL medical coverage, accidental insurance and personal injury, or any other loss or damage.
By checking the corresponding box on the NMC Registration Form, I state that I have read, understood, and hereby grant permission for my youth/child to participate fully in the activity described above and agree to these waivers and conditions.