Bus Ministry Release Form

Students Name*

First Last

Students Name

First Last

Students Name

First Last

Address Student will be picked up/dropped off*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parant/Guardian Name*

First Last

Phone Number*

Emergancy Contact #2*

First Last

Phone Number*

COVID-19 Release*

I understand that if my student is running a fever or has been in contact with anyone who has tested positive for COVID-19 in the past 24 hours they will not be aloud to board the Church vehicle or take part in our services that week.

Emergency Release*

My student(s) may be attending different events with First Free Will Baptist Church during the 2020-2021 school year. In the event that my student should need emergency medical attention, First Free Will Baptist Church and/or any adult volunteer or employee is hereby authorized to provide emergency medical care, including without limitation; medical, dental, surgical care or hospitalization, to my student as recommended or suggested by a physician, nurse, surgeon, or other healthcare professional. I understand that in the event medical intervention is needed, every attempt will be made to contact immediately the persons listed on this form. In the event I cannot be reached in an emergency during the activities taking place in the 2020 calendar year, I hereby give my permission to the physician or dentist selected by the activity leader to hospitalize, to secure medical treatment, or order an injection, anesthesia, or surgery for my child as deemed necessary.

Transportation Release*

I hereby release First Free Will Baptist Church, as well as its directors, coordinators, employees, or other agents from all liability or damages for any and all injuries arising from the negligence of any of the above while traveling to this activity via private vehicle or church van.

Is there any other information about your student that you feel we should know to better help us minister to them?

Bus Release Form

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