Greeley Vineyard Church  Kids/Youth Waiver Form

I give permission for my above-named teenager to join the youth community at Greeley Vineyard Church for the field trips below. I also understand that the group will be traveling by personal vehicles to these events, and give my student permission to do so.

I release Greeley Vineyard Church, its staff and sponsors, and Youth Directors from responsibility and liability for any injury or illness that my child may sustain during these activities. In the event of an emergency, I authorize the Youth Directors, as agent for me, to consent to any emergency medical treatment, such as: x-ray
examination; medical, dental or surgical diagnosis; treatment; and hospital care advised and supervised by a physician, surgeon or dentist (as appropriate) licensed to practice under the laws of the state where the services are rendered, either at a doctor’s office or in any hospital. I expect to be contacted as soon as possible.
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