Six Flags Permission Form

Six Flags Permission Form Must be signed by both participant and parent/guardian and turned in by June 29th with payment of $80.00

Code of Conduct: Observe the rules posted and those verbally communicated to you during the trip. Be on your best behavior and respect one another and your environment. Respect authorities, the Northside Staff and Volunteers at the event and remember you are representing Northside United Methodist Church and each other. Pay for property damaged or destroyed. In the case of an emergency, parents will be notified. The chaperones will do everything in their power to make sure each youth is safe and will receive the proper medical attention at the time of any incident. Participants will always be with 3 or more people while traveling in the park. All participants will respect the church that we are spending the night in and agree to leave it better than we found it. You will not go in the sleeping areas of the boys if you are a girl and will not go in the sleeping areas of the girls if you are a boy. Refrain from the use and possession of alcohol, cigarettes and/or drugs. All participants must respect others’ physical boundaries. Inappropriate behavior (i.e. sexual harassment, bullying, and rough housing) is not permitted. It is expected that all participants will not alter their physical appearance on the trip example: tattoos, piercing, hair cuts or dying of hair etc. Youth may use their cell phones. We ask that participants use their phones responsibly. Please answer your phone when a chaperone calls. Please do not use cell phones during worship services, devotions…etc. No PROFANITY by adults or participants

Participant Name Printed: ______Participant Signature: ______Participant’s Cell Phone Number: ______

Emergency and Medical Information

Any known Food or Medicine Allergy: ______Taking any Meds: ______Medical conditions we should be aware of: ______Insurance Provider & Policy Number:______

Guardian: By signing, I am stating that I agree with the codes of conduct. I also understand that each participant is in a safe environment and do not hold Northside UMC, or any staff or volunteer liable for any illness or mishap during the event. I understand that if my child gets removed from the trip I am financially responsible for the trip and the extra cost of having my child go home early. I authorize treatment by an accredited hospital and/or physician as needed for my child.

Parent/Guardian Name Printed: ______Parent/Guardian Signature: ______Cell Phone #: ______