Gospel Centre Overnight Permission Form (Fall Retreat 2024)

Registration Deadline: November 5th, 2024
Destinations: Gospel Centre Pentecostal Church, Camp Nakamun
Individual(s) in Charge: Pastor Gabriel Banaag
Drop Off: Gospel Centre Church - Friday, 5:45PM (bus leaves at 6:15PM)
Pick Up: Gospel Centre Church - Sunday, 2:30PM
Mode of Transportation: Bus
Student Cost: $100/student

Student's Information

Name of First Student

Name of Second Student

Name of Third Student

Address

Alberta Health Care # of First Student

Alberta Health Care # of Second Student (required if there's a second student)

Alberta Health Care # of Third Student (required if there's a third student)

Grade of First Student

Grade of Second Student

Grade of Third Student

School of First Student

School of Second Student

School of Third Student

Gender

Female Male

Gender of Second Student Male Female

Gender of Third Student Male Female

Allergies - Does this student(s) have any allergies or dietary issues that we should be aware of? Please specify the name of the student with the allergy or dietary issue. Please list them below:

Do you have any special instructions or physical, emotional, mental, or behavioral concerns/limitations for this student that we should be aware of?

Parent/Guardian's Information

First Parent/Guardian's Full Name

First Parent/Guardian's Cell Phone

First Parent/Guardian's Email

This address will receive a confirmation email

Address (if different than above)

Second Parent/Guardian's Full Name

Second Parent/Guardian's Cell Phone

Second Parent/Guardian's Email

For the Student

Youth Group Policy for Events (PLEASE READ CAREFULLY) *On outings you represent our church, youth group, friends and families and most importantly Jesus Christ. Your actions show your character. Please be appropriate. *The use of drugs or alcohol, any infractions of the law, weapons, sexually related activities, fighting, cussing, vandalism, pranks & disrespect of authority will not be tolerated at any Gospel Centre Pentecostal Church Youth Group activities. *During sleep over events youth are required to stay in designated areas and no other friends are allowed to visit. *Any youth who is 18 years or older and is still participating in the youth group as a youth is required to follow all the rules of a minor. *If a specific individual(s) is identified who has broken this policy, they will be asked to leave the function. If individual(s) cannot be identified then the function will end and everyone will be asked to leave. *PDA is not acceptable at any time while on youth group events or activities. Dating couples should remember to set a Christian example to everyone. Physical contact should be kept to a minimum. Holding hands is the limit of PDA that is allowed of all in the youth group. *To encourage the growth of relationships and interaction among those in the youth group while traveling, no audio players, video games, and/ or cellular phones will be allowed at any time. Audio players and video games may be allowed on extended trips (i.e., anything over seven (7) hours). Absolutely nothing may be played or listened to that is questionable. (USE COMMON SENSE AND CHRISTIAN PRINCIPLES!). *Clothing should be modest at all times, especially at the pool. That is, if you have doubts about what you are wearing or taking to wear, it is probably not acceptable. No showing of anything that is normally covered by clothing will be acceptable at any time. If in doubt about appropriate clothing, please first check with your parents or if already in attendance at an event or activity, check with an adult chaperone.

Signature of First Student

Signature of Second Student

Signature of Third Student

Date Signed

General Info, Permissions & Legal Consent

My child has permission to participate in all activities under the supervision of Gospel Centre Pentecostal Church Youth group chaperones. My child may also ride in any vehicle designated by the adult in whose care the minor has been entrusted while attending and participating in activities sponsored by Gospel Centre Pentecostal Church. I further grant permission for my child to be examined by a physician or nurse in case of accident or illness if taken to an emergency room. I understand I will be contacted immediately. My Child also has permission to be a part of this offsite/overnight event. I understand that my child will be expected to adhere to the rules and regulations of the youth group. Failure to do so may result in dismissal from the activity.

Parent/Guardian Signature

Date Signed

WAIVER: I hereby give permission for my child to be photographed and/or filmed without any reimbursement of any kind due to me or the need to pay any fee. Gospel Centre Pentecostal Church considers all information personal and confidential and will only use it within the church for ministry or other church related activities and will not release it to outside parties or organizations.

Yes No

Parent/Guardian Signature

Date Signed

Emergency Contact Name

Emergency Contact Phone Number

Gospel Centre Pentecostal Church considers all personal information as confidential and will not release it to outside parties or organizations. However, by completing this form, you are providing consent for this information to be used within the church for ministry and other church related activities. when using photos of Gospel Centre events, either on our website or on Gospel Centre's Facebook page, we try to post photos that would not be considered objectionable. We will remove any photo immediately upon request.

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Gospel Centre Overnight Permission Form (Fall Retreat 2024)

Description

Please Fix the Following