Nazarene Medical & Civil Liability Release form - SP26

    IT IS YOUR RESPONSIBILITY TO READ AND UNDERSTAND THIS FORM BEFORE SIGNING

    Clergy Kids Retreat

    Event Dates: February 14, 2026 - February 16, 2026Due Date: Upon Registration

     
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    IF YOU ARE UNDER 18 YEARS OF AGE, A PARENT OR LEGAL GUARDIAN MUST READ & SIGN THIS FORM

    Parent Information
    Add $nth Emergency Contact
    “I, authorize Event leadership to care for the administration of general first aid treatment for any minor injuries received to my child during the event. If the injury sustained is life-threatening, or in need of emergency treatment, I authorize the leadership of or its representative to summon any and all professional emergency personnel to attend, transport, treat my child.

    I understand that event staff will require my son/daughter to make choices and keep a schedule, and that he/she may not be under direct adult supervision at all times. Unless there is negligence on the part of any staff or lay assistants of Nazarene Youth International Ministries, the General Church of the Nazarene, and/or Mount Vernon Nazarene University, I agree to release and hold harmless any staff and lay assistants of Nazarene Youth International Ministries, the General Church of the Nazarene, and/or Mount Vernon Nazarene University, from any and all claims, suits, costs and actions, of any kinds whatsoever, arising from their exercise of the power granted by this authorization.
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    (or Parent/Legal Guardian, if Participant is under 18 years of age)