NAYC Parent/Guardian Consent/Release Form

Your name *

Email address *

Student information

Name *

Birthdate *

Phone number *

Address *

Medical Information *

Indicate any illness or allergies of which we should be aware: Also, if the student will be taking any prescription medication please note:

Trip Buddy *

No student may leave the group alone at any time. If they need to go somewhere, or we are sightseeing, trip buddies will be required to stay together at all times.

Parental Consent *

We, the parents/guardians of the student named in this form do hereby give our permission for him/her to attend: North American Youth Congress in St. Louis, MO on July 26 – 28, 2023. By typing your name below, you are giving consent.

We do hereby release and forever discharge The Way Church and their designated chaperones from any/all actions or suits in law or equity which we might hereafter have by reasons of injuries sustained by our son/daughter participating in the above-mentioned activity. In case of emergency, we give permission for our child to be treated at a hospital and/or by a medical doctor.