Please fill out for each child in your family who will participate in New Ground Church's Kids and Student Ministries.

I give permission for my child(ren)* to be transported to and from New Ground Church programs and events. I release New Ground Church and its representatives from all liability for accidents incurred on this trip as long as no church representative has been grossly negligent.

I give permission for my child(ren)’s name, work, photograph, to be used in any New Ground Publications publications, including those online.

In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by church representatives to hospitalize, secure proper treatment for, and to order injections, anesthesia, or surgery for my child(ren)*. In case of an emergency, I understand that every effort will be made to contact me. If I cannot be reached, I hereby give New Ground Church’s staff and/or church representatives permission to act on my behalf in seeking emergency treatment for my child. I also authorize any hospital which has given treatment to my child to release the child to New Ground Church and its adult staff members when treatment is completed. I also release New Ground Church and its representatives from all liability as long as no church representative has been grossly negligent. (Saying no will prohibit your child(ren) from participating in New Ground Church kids and student programs.)

I have read, understood, and completed the New Ground Kids and Students registration form and answered all information to the best of my knowledge. I take responsibility to update New Ground Church representatives should there be any changes.

Typing my name below is providing my digital signature to this form.