GENERAL STUDENT RELEASE

I am the parent and/or legal guardian of the student/child named above. I have the legal authority to execute this release on behalf of the student/child. I consent and grant permission for the student/child to participate in the following activity/event associated with Grace Church Student Ministry. I am adequately informed of the nature of this activity/event. I represent that the student/child is physically fit and capable of participating in this activity/event. I am aware of and assume all hazards and risks associated with this activity/event. I understand and agree that Grace Church is not responsible for the negligence or reckless conduct of others. I hereby release and hold Grace Church, its employees, and volunteers harmless for any injury, claims, or damages suffered as a result of the student/child participating in this activity/event.

I authorize the adult supervisors and any medical treatment providers to take all reasonable and necessary steps to protect the health and welfare of the student/child in case of an accident or emergency. I authorize emergency medical treatment for the student/child in the event I cannot be reached for authorization.

2026 Fusion Retreat | August 28-30

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Aug 28, 2026

Pine Cove Springs

Rachel Hinkle

[email protected]

* To streamline this process, please login here.

* If you do not have a Grace Church account, you can create one here.