Little Parental Consent Form

First Baptist Church of Fredericktown 2014-2015

Please check each section you consent to.
Transportation/Activity Parental Permission
My youth, ______________________, has permission to ride the van/transportation provided by First Baptist
Church, Fredericktown to and from church as well as any church sponsored activities in and around Fredericktown
during the 2014-2015 school year. I understand that participating in the youth group is a privilege. In consideration
of this privilege, I release First Baptist Church from any physical injury or illness, while participating in any church
related activities, including First Baptist Church sponsored travel to and from those activities. By signing below, I
also agree to hold harmless the directors, volunteers, employees and agents of First Baptist Church. I understand
that my child may participate in any number of activities, some of which include, but are not limited to,
recreational activities and games. I understand that there are certain risks associated with any activity and I will
assume responsibility for these risks, whether known or unknown to me at this time.
Permission to Talk With a Minor
I give permission for my youth, ______________________, to talk privately to any of the youth leaders, Daniel
Weyand, Associate Pastor, or Thomas Johnson, Pastor of First Baptist Church of Fredericktown, MO at any time
during the 2014-2015 school year.
Permission to Use Images
The undersigned consent to and authorizes the use of First Baptist Church to any and all photographs and video
images taken during church functions. The use of these images is at the discretion of First Baptist Church for
promotional purposes without compensation to the undersigned.
Behavior Guideline Form
Appropriate behavior is defined as a cooperative and respectful spirit on the part of the individual.
Inappropriate behavior is defined as being defiant, disruptive, belligerent, rude, use of crude language or any other
behavior that is not Christ-like. This is not exclusive to the behavior while on the outing, but includes behavior in
general. Inappropriate behavior will be addressed by the teacher or other leaders and will be handled in the
following manner:
1st offense - verbal warning.
2nd offense - possible loss of privilege to go to the next outing.
3rd offense - automatic loss of privilege to go on outings for a period of time, not less than the next three outings.
The period of time will be determined by the leader and helpers of the outing.
I have read and understand that traveling with the youth group of First Baptist Church on outings is a privilege not
a right. I may forfeit my right to go on outings through continued inappropriate behavior.

Youth Signature_____________________________________Date_____________________________

Parent/Guardian Signature_____________________________Date_____________________________