General Permission Form

If you have a child or youth participating in the Children or Youth Ministry at FXBG Baptist Church, please fill out this permission and consent form for each of your children so that we can make sure to care for your child or youth to the best of our ability.

Name (first, middle, and last name)

First Name

Last Name

Date of Birth

YYYY

Student General Permission

Through this agreement, I give the child or youth listed above the right to go with the Fredericksburg Baptist Church Children or Youth Ministry on various events and outings from September 2025 through August 2026. These events and outings range from concerts and retreats to local recreational activities and mission projects. I realize that this is a general form to be placed on file in the Children & Youth Ministries' offices. The Children & Youth Ministers, staff, and volunteers will use the child or youth's information in outreach and communication through out the year. I also understand that a separate registration form for retreat centers and Passport may need to be filled out on a case by case basis.

Youth Email (if 7th grade+)

Youth Phone Number (if 7th grade+)

(###)

###

####

Current Grade

School

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact Information

Parent/Guardian Name

First Name

Last Name

Parent Email

Parent Phone Number

(###)

###

####

Parent/Guardian Name

First Name

Last Name

Parent Email

Parent Phone Number

(###)

###

####

Emergency Contact Information

Emergency Contact Name

First Name

Last Name

Emergency Contact Phone Number

(###)

###

####

Emergency Contact Relationship

Medical Information

Primary Doctor Name

Doctor Office Phone Number

Last Tetanus Shot

YYYY

Allergies & Medication

Insurance Company

Policy Holder's Name

First Name

Last Name

Policy Holder's ID Number

Group Number

Permission to Use Photo & Video

I give Fredericksburg Baptist Church the right and permission to use my child's photographs and videos in its promotional materials and publicity efforts. I understand that the photographs and videos may be used in a publication, print ads, social media, and any other form of promotion. I understand that my child's name and/or address will not be published in any form.

Initial to Accept

Initial to Decline Photo/Video Release

Date

YYYY

Permission to Medically Treat

If a medical emergency should arise while at the outing/event and I cannot be immediately contacted, I hereby give permission to Fredericksburg Baptist Children and/or Youth Ministry to select a physician and/or hospital for my child's care. I hereby also give the physician and/or hospital, as selected by Fredericksburg Baptist Children and/or Youth Ministry, my permission to hospitalize, medically treat, order injections, anesthetize, or perform surgery as medically necessary for my child, as reasonably determined and advised by proper medical personnel. To the best of my knowledge, I have listed above all of my child's medical allergies, medications being taken, medical problems, and other pertinent information.

Initial to Accept

Date

YYYY

Parent or Legal Guardian Signature

Parent/Guardian Who Filled Out this Form

First Name

Last Name

Relationship to Child/Youth

Consent for My Child/Youth to Participate

I understand that my student will be traveling and participating in activities with Fredericksburg Baptist Church from September 2025 through August 2026. I consent and understand all of the policies and releases listed in this form.

I agree to the above.

General Permission Form

Location of Our Church

Contact Us

Sign Up For Our Email