Church Waiver Form

On June 22 through June 29, 2019, Genoa Church youth will be taking a Mission Trip to the Dominican Republic. 

I understand that personal injury can and may occur to my child, and I hereby authorize Matt Clark, Pastor of Youth, or another appointed youth advisor, to seek and consent to emergency medical attention for my child as needed; and I further agree to be liable for and to pay all costs incurred in connection with such medical attention. 

I hereby release Genoa Baptist Church, its employees, agents, and volunteers, from any and all liability, claims, demands, causes of action and possible causes of action whatsoever arising out of or related to any loss, damage or injury (including death) that may be sustained by my child while participating in or traveling to and from this event. 

I give permission for my child to ride in any vehicle designated by Genoa Baptist Church, its employees and adult volunteers while participating in and traveling to and from this event.

I agree to accept full responsibility, financially or otherwise, for any damage my child may do to any properties visited on this trip, other’s personal property, or vehicles used for transportation.

Church Youth Trip Standards

The following behavior will not be tolerated at any time during this trip . Violation of these standards, or being knowingly in the presence of others violating these standards, can and will result in consequences deemed appropriate by the youth pastor, and advisors of Genoa Baptist Church, including, but not limited to, being sent home immediately at the participant’s expense.

            *Possession or use of alcohol, tobacco, or illegal drugs.

            *Possession or use of weapons, including pocket knives, firearms, and fireworks.

            *Inappropriate sexual behavior.

            *Failure to follow instructions of any of the trip leaders.

Participant Signature *
Parent/Legal Guardian Signature