Tuesday, February 2, 2016

Sleepover Feb 5-6

Talent Show Auditions continues with a sleepover
When: Feb 5th - Feb 6th
7:00pm- 9:00am
For middle school and high school students
You will be expected to learn and practice a new act in our time together.
Snacks and breakfast are provided

Reason to come: We are hosting a fundraising talent show on Feb 26-27.  All participants will be awarded money toward their summer youth trips.

What to Pack:
Sleeping bag & pillow
Comfortable clothes
Pjs
Toothbrush
Musical instrument (if you play one)
Any props/supplies for your act

For Parents and Guardians:
Please complete a medical release form (check to see if we have one on file)
For sleeping arrangements we will be separating the students by gender and into age groups.
Mark your calendars: Required dress rehearsals will be Feb 20 at 5:30pm and Feb 26 at 5:30pm.  
If you have any questions or concerns please contact Andi Berryman the Youth and Family Ministries Director
760-375-9768           
youthandfam@gracelutheran.org


Medical/Liability Release Form
I, ______________________________ parent(s)/guardian(s) of ______________________________ give permission for my teenager to attend and participate in youth activities at Grace Lutheran Church.
                By signing this form the parent, guardian or individual agrees to assume and accept all risks and hazards inherent in participating in any of the activities, events, or trips for this school year. They also agree to not hold Grace Lutheran Church and /or its owners, agents, or employees liable for damages, losses, or injuries to the person(s) or property undersigned. Risks include but are not limited to death, injury due to being a passenger in a car on route to and from home, injury due to standing, sitting, walking, climbing, and falling in or around car, or where the car is parked; any injuries due to indoor and outdoor activities, injuries due to water, sand, sun, or weather, and any injuries by participating in physical games, and risks of personal property lost or stolen. The parents or guardians understand that they are signing for the minors listed on this form, and that their signature is both a medical and liability release. I allow my child to ride with any driver endorsed by Grace Lutheran Church during these activities, events or trips.

AUTHORIZATION TO CONSENT TO TREATMENT
We do hereby authorize Grace Lutheran Church, as agents for the undersigned to consent to any X-ray examination, anesthetic, medical, or surgical diagnosis or treatment or hospital care which is deemed by, and is to be rendered under the provisions of the Medical Practice Act on the Medical Staff of a licensed hospital. Whether such diagnosis or treatment is rendered at office of said physician or said at hospital. This permission includes any necessary dental treatment to be performed by a licensed dentist under the provision of the Dental Practice Act. It is understood that this authorization is given in advance of any specific authority and power on the part of the aforesaid agents to give specific consent to any and all such diagnosis, treatment, or hospital care which the aforementioned physician in the exercise of his/her best judgment may deem advisable. This authorization shall remain effective during the entirety of the 2015-2016 school years and expires on August 12, 2016.

Parent/guardian signature and date

Address: Street Address, City and State

Best contact phone number

Emergency contact name and relation to minor                                                 Emergency phone number

Insurance Carrier Name                                                                                                Policy number

Family Doctor’s Name and Phone Number

List any allergies to medications or food


Any additional information I need to know to help keep your teenager safe?



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