VERTICAL (youth) Annual Release Form

Complete this form (with your child/teens information)

Your name *

Email address *

Birthdate

Parent/Guardian Primary Emergency Contact Number

Parent/Guardian Primary Email Contact

Medical notes for my child (allergies, etc)

Insurance Provider (if applicable)

Release Form *

With the understanding that every effort will be made to contact me or my alternate responsible party prior to emergency surgical procedures (unless the particular situation does not allow due to the threat of loss of life in relationship to any event for which I register or allow my child to attend, I give permission for First Baptist Church of Wildwood of Florida to:

provide transportation during the entirety of the event.

restrict my child from any activity that they do not feel is within their physical capabilities.

use any videos or photographs taken of the above named child to be used with internal social media or publicaitons..

provide the necessary medical services in the event that my youth is injured or becomes ill.

be released from any and all claims, demands, actions or causes of action, past, present, or future arising out of any damage or injury while participating in a church-sponsored event.

Primary Parent/Guardian Name *

Today's Date