In case of drop-off events, please list an alternate pick up person, if any.
Participant 1 Information
Participant 2 Information
Participant 3 Information
Medical & Liability Release
During activities at or sponsored by St. Martin-in-the-Fields Episcopal Church, in the event of sickness or medical emergency, I request that my child receive any medical attention or treatment deemed necessary. I give permission to any hospital, doctor, or health care provider to transport, treat, admit, and/or care for my child. In the event that I am not present at the time of the emergency or cannot be contacted, I entrust my child's care to the staff and/or designated ministry leadership of St. Martin-in-the-Fields Episcopal Church & School.
I grant to St. Martin-in-the-Fields Episcopal Church and to the Episcopal Diocese of Fort Worth, their representatives and employees the right to take photographs, video recordings, and sound recordings of my child. I authorize St. Martin-in-the-Fields Episcopal Church and to the Episcopal Diocese of Fort Worth its assigns and transferees to alter, copyright, use and publish the same in print and/or electronically, with or without my child's name, for any lawful purpose, including such purposes as publicity, illustration, advertising, displays, and internet content. I hereby waive any right that I may have to inspect or approve photo, video, or sound products. In addition, I waive the right to any compensation related to their use.
If you do not waive the right to photos, videos, etc. please provide an image of your child to better assist us with assuring their likeness is not used.
If you have additonal children, please fill out a second form.
COMMUNITY GUIDELINES FOR ST. MARTIN-IN-THE-FIELDS EVENTS
To establish a Christian community during our events, the following guidelines are to be used for our life together. The success and enjoyment of our experience in Christian fellowship will largely depend upon our mutual responsibility to one another and to God. Participants who break the following community guidelines may be asked to leave and guardians may be called. 1. As Christians, all participants have a responsibility to respect the environmental settings where our events are held, including buildings grounds, furnishings and natural wildlife. Participants will be held financially responsible for damages they incur. 2. Participants may not leave designated buildings or areas and will participate in all group activities unless given express permission by an adult event facilitator to do otherwise. 3. Participants will take responsibility for themselves by dressing appropriately. It is not suitable to wear clothes that expose undergarments (bras, boxers, etc.). A participant may be asked to change clothes if an adult event facilitator decides that their attire is inappropriate. 4. Electronic devices, sporting goods, and toys tend to be a distraction to the individual and to others and should be left at home. If they are brought, their use may be restricted, or they may be confiscated. 5. Show consideration and respect for others. Lights out, quiet times and prayer times are a few examples of when to demonstrate your thoughtfulness and silence. Offensive language is not considerate or respectful to the community. 6. Use of alcohol, artificial stimulants (Vivarin, NoDoze, etc.) or illegal drugs is prohibited. 7. Use of any tobacco product is prohibited. 8. Inappropriate displays of affection or sexual activity are not permitted. 9. Youth who drive their own cars may be asked to turn in their keys to an adult event facilitator before an event begins. 10. Children will not be released prior to the close of an event without written guardian consent. If question of legal guardianship arises, consent is required from both parents. 11. Trust, accountability and safety are essential in church activities. The policies of Safeguarding God’s People will be in place in all church events.