2026 Student Ministries Waiver

Please put student's name in the First name Last name boxes. Parents/guardians can put their email in the email address box.

Your name *

Email address *

Please provide students name. *

I/We, the undersigned, hereby grant _____________________________ (son/daughter) my/our permission to attend and participate in the activities off-campus (such as gyms, nursing homes, restaurants, concerts, camps) and all activities included the student ministry.

Please provide students name. *

I/We do hereby give permission for______________________________________ (son/daughter) to ride in any vehicle designated by the Youth Staff members in whose care the minor has been entrusted while attending and participating in activities sponsored by Solid Rock Bible Church I/We further release and hold harmless the above named organizations, the individual Volunteer Staff Members, and all Solid Rock Bible Church members from any liability for loss, injury or damage to my son/daughter or property which may result from his/her participation. The duration of this agreement is one year and lasts for the time slot designated above. We also release the use of pictures taken at student events for use on Solid Rock’s website and social media.

Name of parent/guardian filling out this form *

By checking this box, I acknowledge that this serves as my electronic signature. *

Parent Name (s) and Cell Phone (s) *

First name Last name: (123) 456-7890

Alternate Emergency Contact and Phone Number *

Name and number

Insurance Company *

Policy Holder

Policy Number *

Allergies

Medications now being taken

Other health concerns (if any)

Solid Rock Adult Staff has permission to give my student over-the-counter medications for minor ailments if they occur while on the activity? *

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