Statement of Permission to Provide Medical Care
TO WHOM IT MAY CONCERN:
In case of an emergency, I give Kirby or Jackie O’Brien or Josh Mishler, or Mike or Rhonda Cochran permission to seek medical treatment for my son/daughter, ________________________________________, in the event immediate treatment is necessary and I cannot be reached during the MK Sky Ranch Retreat trip during the dates of September 2-4, 2005.
| __________________________________ |
__________________ |
| Parent/Guardian Signature |
Date |
In an emergency, the parents can be reached at:
_____________________________________________________________
Acceptance of Responsibility For Adhering to Activity Rules
Participation in MK Youth Group activities is conditional upon adhering to a few basic rules, for the protection and
enjoyment of the whole group. The following activities will not be permitted:
- Smoking.
- Drinking of alcoholic beverages of any sort.
- Use of any illegal drugs.
- Use of foul language in any language.
- Skinny dipping or water activities in underclothes in mixed company.
- Couples by themselves away from the group.
We do not allow firearms of any sort, and restrict knives to only those appropriate for camping activities.
We expect everyone to be in by “lights out”, and not to engage in anything but necessary activities until morning.
PARENTS:
I understand and support the rules presented above, and will do what it takes to remove my teen from group activities
should he/she violate those rules.
| __________________________________ |
__________________ |
| Parent/Guardian Signature |
Date |
TEENS:
I understand and support the rules presented above, and understand that if I break the rules, steps will be taken to
terminate any participation in group events.
| __________________________________ |
__________________ |
| Participant |
Date |