HCY Permission/Waiver 2025 • City Life Church

City Life Youth @ HCY Conf - Permission & Release of Liability Form

Destination: Home Church, Red Deer AB

Event: HCY CONF - Home Church Youth Conference

Method of transportation: Driving/Bus

Supervision provided by: City Life Team: Melissa Blackwood, Jaz Narciso, Samara Prescott, Mandie Van Wyk, Luc Boyd, Shayna Admiraal, Angelica Angeles, Brett Baynes, Peter VanRaamsdonk, Seth Cottrell, Dami Adegoke

Date: Friday Feb.21st - Sun Feb.23rd, 2025

Departure Time: 5:15pm, Fri Feb 21st (we will be leaving 5:15pm sharp, please arrive at the chuch at 5pm)

Approx. Return Time: 11:30am on Sun Feb 23rd. We will be arriving back at City Life to attend our Sunday Church Service.

Specifics of all Activities: Driving to Red Deer in a bus. There will be food provided, high intensity-interactive games, a concert, messages and singing. We will be staying overnight at a hotel. Guys and girls will be separated. We are attempting to have a leader for every room, but there may be some rooms without a leader, these rooms will be closely supervised to the best of our ability.

We will be searching all personal bags upon arrival at the church. Any illegal substances/items will be confiscated, at the leaders discretion. If your child has any necessary medication, please disclose to a CLY leader before hand.

Please note: we encourage students to leave their phone/devices at home, however if they are brought, there will be screen-free times when phones are collected by the leaders. (including bus travel time and hotel times, there will be a curfew).

Please check out the City Life Webpage for a full list of packing information: https://cty.lc/conf

I am a *

This form must be read and signed by a parent or guardian if the participating student is under the age of 18.

All physical activities have risks. I agree to allow my child to participate in this event knowing there are physical risks and hazards inherent in an activity.

All physical activities have risks. I agree to participate in this event knowing there are physical risks and hazards inherent in an activity.

Home Church Wiaver

Photos & Video:
I give permission for myself to be interviewed, photographed, or video-taped for display both inside and outside the church.

In Case of Illness or Accident:
I give authorization for church leadership to sign consent for necessary medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for myself if I am unable to authorize it myself.
I will assume financial responsibility in case of injury, or accident while taking part in Home Church activities and Youth Program Events. I agree to hold blameless Home Church, its pastors, staff and volunteers from and against any loss, damage or injury suffered by the participant as a result of being part of the activities and events of Home Church. This also includes any medical treatment authorized by the leadership representing the church. This consent and authorization is only effective when I am participating in activities and events of Home Church.

IMPORTANT NOTE:
I understand that if I do not comply with rules and expectations placed by HCY leaders, I agree that I will be asked to leave the event and will do so cooperatively.

Home Church Waiver

Photos & Video:
We (I) give permission for my children to be interviewed, photographed, or video-taped for display both inside and outside the church. It is understood that these activities will be properly supervised.

In Case of Illness or Accident:
In the event of a serious illness or accident we (I) understand that the church leadership will attempt to contact us ASAP.
If this is not possible, we (I) give authorization for church leadership to sign consent for necessary medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for our child.
We (I) will assume financial responsibility in case of injury, or accident while taking part in Home Church activities and Youth Program Events. We (I) agree to hold blameless Home Church, its pastors, staff and volunteers from and against any loss, damage or injury suffered by the participant as a result of being part of the activities and events of Home Church. This also includes any medical treatment authorized by the leadership representing the church. This consent and authorization is only effective when our children are participating in activities and events of Home Church.

IMPORTANT NOTE:
If my child does not comply with rules and expectations placed by HCY leaders, I agree that I--the parent--will be contacted and will come pick up my child wherever they might be.

Acknowledgement: *

Request for Permission to Participate

I voluntarily agree to allow my child to participate in this event. By voluntarily allowing participation, I agree that I am exposing my child to inherent risks and hazards. I agree to accept all risks and hazards and be responsible for any injury or other loss which may occur during the participation of my child.

I have read the information above, and I release City Life Christian Centre – Church & Ministries Alberta and all of its employees or volunteers from any and all liability for any and all harm arising to my son/daughter as a result of this trip, and waive any claims against them.

Parent/Guardian Info:

Name of Parent/Guardian *

Parent/Guardian Contact Information (phone number and email) *

I have read the above information and understand that by checking the boxes below I agree that I am the parent/legal guardian of the above named child. *

I agree

I do not agree

I have read the above form with my child and understand that by participating in the activity as described, we are assuming the risks associated with doing so. *

I agree

I do not agree

In the event of emergency, we can contact the person(s) below at the following phone numbers (please include name and number): *

Participant info:

First Name *

Last Name *

Date of Birth *

My child, name above, has permission to participate in the above mentioned activity. *

I agree

I do not agree

Doctor's Name

In the event of emergency, we can contact the person(s) below at the following phone numbers (please include name and number):

Alberta Health Care Number *

Is there anything the leaders needs to be aware of when giving any of the approved over-the-counter medications to your child? (Tylenol, Ibuprofen, Advil or Benadryl in case of minor head ache, cramps, pain relief or allergic reaction) *

Will your child be taking any medications or require any treatments during the trip? *

Tip: medications must be in original packaging

Does your child have any particular allergies or medical conditions which would prohibit them from participating in this endeavor, or restrict the student's participation in any way? *

Yes

If yes, indicate what precautions should be taken prior to the event. IF YOUR CHILD HAS ANY FOOD ALLERGIES, PLEASE GIVE US A LIST OF OPTION OF ALT. FOOD WE CAN PROVIDE FOR DINNER *

As we are staying in hotels, this will requires teens to share beds with each other. If your teen has a specific request of someone they would like to share a bed with, please write down ONE name (first and last) of who your teen would feel comfortable sharing a bed with. This is not guaranteed, but we will do our very best to accommodate as much as we are able to. (If you have no requests, please write n/a) *

I fully understand and agree to the above terms, please type your full name in agreement *

Agreement with Youth

I will follow instructions given to me by the leaders. *

I agree

I do not agree

I will NEVER leave the grounds in which the event is taking place. *

I agree

I do not agree

I will follow instructions regarding curfew and sleep time. No all nighters will be permitted. *

I agree

I do not agree

City Life Waiver & Release of Liability

This is a legal document. By signing this document you are agreeing to give up certain legal rights, including the right to sue or claim compensation. You are also assuming certain obligations, please take the time to read before you sign.

This agreement releases City Life Christian Centre – Church & Ministries Alberta from all liability relating to injuries that may occur during the HCY Conf and travel to/from Red Deer, Alberta. By signing this agreement, I agree to hold City Life Christian Centre – Church and Ministries Alberta entirely free from any liability, including financial responsibility for injuries incurred.

I hereby acknowledge that I have voluntarily joined in the following activities. Driving to and from Leduc to Red Deer, participation in the HCY Conf.

Acknowledgement

I agree

I do not agree

I also acknowledge the risks involved in driving & participating in a conference. These include, but are not limited to, car accidents and injury. I confirm that I am participating voluntarily, and that all risks have been made clear to me. Additionally, I do not have any physical or medical conditions that will increase my likelihood of experiencing injuries while engaging in this activity. I may receive training from City Life in connection with my participation in these activities, including the training listed below, but I acknowledge that in all events I accept that it is my responsibility to become adequately informed and trained or skilled with regard to the activities to be undertaken so as to avoid injury.

Acknowledgement

I agree

I do not agree

I understand that my participation in HCY Conference may have undesired and unanticipated consequences. Notwithstanding this, I hereby release and forever discharge City Life Christian Centre – Church and Ministries Alberta and all affiliates, members, directors, leaders, volunteers and employees from any and all actions, causes of action, suits, claims, demands, liabilities, including negligence or breach of duty of care, and expenses I have now, or may have in the future in connection with, arising from or related to my involvement with or participation in this activity. I will also make every effort to obey safety precautions as listed in writing and as explained to me verbally. I will ask for clarification when needed.

Acknowledgement *

I agree

I do not agree

I fully understand and agree to the above terms, please type your full name in agreement *