GCC Minor Waiver 2026 (MS & HS)

Minor Participant Consent Form & Medical Release for 2026
Gospel Community Church
January 2026 - December 2026

Your name *

Email address *

Release

I, the undersigned, certify that I am the parent or legal guardian of

(List first and last name of each child:) *

(hereafter the “minor child”).

Release continued

I hereby give my consent to have my minor child participate in the following activities (listed on the next page) of Gospel Community Church of Santa Cruz (hereafter “the activities”) on or about January 1st, 2026 to December 31st, 2026 and during the entire duration of the calendar year. I recognize that there are risks involved in participating in the activities and hereby assume all risk of injury, harm, damage, or death to my minor child in connection with his/her participation in the activities. To the fullest extent permitted by law, I release Gospel Community Church of Santa Cruz, its trustees, officers, directors, employees, agents and representatives from any injury, harm, damage or death which may occur to my minor child while participating in the activities and agree to save and hold harmless Gospel Community Church of Santa Cruz, its trustees, officers, directors, employees, agents and representatives from any claims arising out of my minor child’s participation in the activities. Further, being the parent or legal guardian of the minor child, I do consent to any medical, surgical, x-ray, anesthetic, or dental treatment that may be deemed necessary for my minor child. I understand that efforts will be made to contact me prior to treatment but, in the event I cannot be reached in an emergency, I give permission to the activities leader to make the decisions necessary for treatment. Should there be no activities leader available, I give permission to the attending physician to treat my minor child. As parent or legal guardian, I understand that I am responsible for the health care decisions of my minor child and agree that my insurance plan is the primary plan to pay for the medical, dental, or hospital care or treatment that is given to my minor child. Any insurance policy of the church or organization sponsoring this event will be used as the secondary coverage.

Do you consent to the above statement? *

Please check each event or activity below that you are consenting to your child participating in: *

As the parent or guardian, by putting your initials in the boxes below you sign off on the activity listed and accept the risks associated with the activity (risks stated in the next question).

Winter Camp

Summer Camp

Youth groups meetings (both official & unofficial gatherings)

Special Events (including but not limited to beach days, boardwalk trips, bonfires, fast food excursions, theme park trips, etc.)

Post-meeting outings (Sunday lunch, post-youth group hang outs, etc)

I understand that the above activities may result in any of the following: *

Any of these activities may result in injury, harm, damage, or death in the following ways: sunburn, broken bones, injuries to muscles, injuries to tendons, cuts, bruises, eye injury or damage resulting in sight loss, head injury or damage, injury to skin, injury to hearing or hearing loss, injury or damage from insects or animals, injuries due to car accident, food poisoning, drowning, death. Activities may result in growth in the knowledge of Jesus, conversion to Christianity, adherence to Biblical beliefs, and even baptism.

E-Signature of Parent or Guardian 1 *

E- Signature of Parent or Guardian 2

E- Signature of Minor(s) *

Today's Date *

Medication Release

I hereby give my consent to have my minor child to receive the following medication at the manufacturer recommended dosage during any of the above consented to activities of Gospel Community Church of Santa Cruz on or about January 1st, 2026 to December 31st, 2026 and during the entire duration of the calendar year. Any official Gospel Community Church volunteer or leader has permission to administer the following initialed medications at their discretion, without contacting the minor child's parent(s) or guardian(s).

(List first and last name of each child:) *

(hereafter the “minor child”).

Please select 'Yes' or 'No' next to each medication below.

A 'Yes' answer gives Gospel Community Church permission to administer the selected medication.

Ibuprofen *

Such as Advil and other brands

Acetaminophen *

Such as Tylenol and other brands

Antibiotic Ointment *

Such as Neosporin and other brands

Antihistamine Medication *

Such as Benadryl and other brands

Medicated Burn cream *

E-Signature of Parent or Guardian 1 *

E- Signature of Parent or Guardian 2

Today's Date *

A copy of your responses will be sent to your email address.