• 306 Park Ave, Fort Lupton, CO 80621
First United Methodist Church Fort Lupton
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Permission & Release Form

Children & Youth

Statement of Release

Fill out all parent permissions below.

Name of Parent or Guardian(Required)
Person filling out this form who is legally providing permission and release.

Permission to Participate

I, the person submitting this form as parent or legal guardian, hereby give consent for the child(ren) listed below to attend the children & youth activities sponsored by The First United Methodist Church of Fort Lupton, CO.
List all children with permission to participate(Required)
One form per family. Click plus (+) icon to add more children.
Child's Full Name
 

Permission to Transport

I, the person submitting this form as parent or legal guardian, give my permission for the staff/volunteers of the First United Methodist Church of Fort Lupton to transport my child(ren) by car, church van, bus or on foot to any of the outings during children & youth activities.
List all children with permission to transport
One form per family. Click plus (+) icon to add more children.
Child's Full Name
 

Permission for Emergency Care

In the event of serious illness or injury when neither parent can be reached, I, the person submitting this form as parent or legal guardian, give my permission for an ambulance to transport my child if necessary and for the staff/volunteers of any chosen hospital to give necessary treatment to my child in the event of an accident or other emergency. I agree to accept financial responsibility for any medical transport or care, child requires.
Emergency Care Permission Agreement(Required)

Allergies/Medical Conditions

Please provide as applicable for each child in your family.
List all children with medical information(Required)
Child's Full Name
Allergies/Medical Conditions
 

Permission to Walk Home

I, the person submitting this form as parent or legal guardian, give my permission for the children listed below to walk or bike home from children & youth activities.
List all children with permission to walk or bike home(Required)
One form per family. Click plus (+) icon to add more children.
Child's Full Name
 

Picture Release

I, the person submitting this form as parent or legal guardian, give my permission to the First United Methodist Church to use any pictures/videos taken of my child(ren) listed below in newspapers, displays, on the church web page or any other publication used to promote or educate others about CLC/Youth Group or the church.
List all children with permission for picture release(Required)
One form per family. Click plus (+) icon to add more children.
Child's Full Name
 
Sign with mouse, stylus or finger.