Talent
Show Auditions continues with a sleepover
When:
Feb 5th - Feb 6th
7:00pm-
9:00am
For
middle school and high school students
You
will be expected to learn and practice a new act in our time
together.
Snacks
and breakfast are provided
Reason
to come: We are hosting a fundraising talent show on Feb 26-27. All participants will be awarded money toward
their summer youth trips.
What to
Pack:
Sleeping
bag & pillow
Comfortable
clothes
Pjs
Toothbrush
Musical
instrument (if you play one)
Any
props/supplies for your act
For
Parents and Guardians:
Please
complete a medical release form (check to see if we have one on file)
For sleeping
arrangements we will be separating the students by gender and into age groups.
Mark your
calendars: Required dress rehearsals will be Feb 20 at 5:30pm and Feb 26
at 5:30pm.
If you have
any questions or concerns please contact Andi Berryman the Youth and Family Ministries
Director
760-375-9768
youthandfam@gracelutheran.org
Medical/Liability Release
Form
I, ______________________________ parent(s)/guardian(s) of
______________________________ give permission for my teenager to attend and
participate in youth activities at Grace Lutheran Church.
By
signing this form the parent, guardian or individual agrees to assume and
accept all risks and hazards inherent in participating in any of the
activities, events, or trips for this school year. They also agree to not hold Grace Lutheran Church and /or its
owners, agents, or employees liable for damages, losses, or injuries to the
person(s) or property undersigned. Risks include but are not limited to death, injury due to being a passenger in
a car on route to and from home, injury due to standing, sitting, walking,
climbing, and falling in or around car, or where the car is parked; any
injuries due to indoor and outdoor activities, injuries due to water, sand,
sun, or weather, and any injuries by participating in physical games, and risks
of personal property lost or stolen. The parents or guardians understand
that they are signing for the minors listed on this form, and that their
signature is both a medical and
liability release. I allow my child to ride with any driver endorsed by Grace
Lutheran Church during these activities, events or trips.
AUTHORIZATION TO CONSENT
TO TREATMENT
We do hereby authorize Grace
Lutheran Church, as agents for the undersigned to consent to any X-ray examination,
anesthetic, medical, or surgical diagnosis or treatment or hospital care which
is deemed by, and is to be rendered under the provisions of the Medical
Practice Act on the Medical Staff of a licensed hospital. Whether such
diagnosis or treatment is rendered at office of said physician or said at hospital.
This permission includes any necessary dental treatment to be performed by a
licensed dentist under the provision of the Dental Practice Act. It is understood
that this authorization is given in advance of any specific authority and power
on the part of the aforesaid agents to give specific consent to any and all
such diagnosis, treatment, or hospital care which the aforementioned physician
in the exercise of his/her best judgment may deem advisable. This authorization
shall remain effective during the entirety of the 2015-2016 school years and
expires on August 12, 2016.
Parent/guardian signature and date
Address: Street Address, City and State
Best contact phone number
Emergency
contact name and relation to minor Emergency phone
number
Insurance Carrier Name Policy
number
Family Doctor’s Name and Phone Number
List any allergies to medications or food
Any additional information I need to know to help keep your
teenager safe?
