Volunteer Parental Consent

Please read the Volunteer page prior to completing the online permission form. Once this form is complete, your student's Team Leader status will be confirmed.

Student First Name

Student Last Name

Parent/Guardian Details

Parent/Guardian Name

Phone

Secondary Emergency Contact

Secondary Emergency Phone

I give my child permission to participate in St. Johns County Safety Town and I understand the hours are Sunday, July 18 from 5:00 p.m. - 7:00 p.m. for training and then Monday, July 19 through Friday, July 23 from 8:00 a.m. - noon for Safety Town at Crosswater Community Church.

Agreed

Waiver and Release: In considerationof St. Johns County Safety Town granting my child the opportunity of participating in the Safety Town camp as a Team Leader at Crosswater Community Church, I agree to assume the risk of such activity and further agree to release, hold harmless, and indemnify St. Johns County Safety Town and Crosswater Community Church, its employees, agents and independent contr

Please read the Volunteer page prior to completing the online permission form. Once this form is complete, your student's Team Leader status will be confirmed.

Student First Name

Student Last Name

Parent/Guardian Details

Parent/Guardian Name

Phone

Secondary Emergency Contact

Secondary Emergency Phone

Please include any allergies/medications needed.

Please list 3 adjectives that describe your child!

I give my child permission to participate in St. Johns County Safety Town and I understand the hours include a training day plus Monday, July 8 through Friday, July 12 from 8:00 a.m. - noon for Safety Town at Crosswater Community Church.

Agreed

WAIVER AND RELEASE: In consideration of St. Johns County Safety Town granting my child the opportunity of participating in Safety Town as a Team Leader at Crosswater Community Church, I agree to assume the risk of such activity and further agree to release, hold harmless and indemnify St Johns County Safety Town and Crosswater Community Church, its employees, volunteers, agents and independent contractors conducting the camp from any and all claims, suits, losses or related causes of action for damages, including but not limited to, such claims that may result from my child's injury or death. Furthermore, this release bars claims by the undersigned's children, spouse, heirs, assigns, executors and administrators. In the event of an emergency and if all reasonable attempts to reach parents/guardians with given phone numbers is unsuccessful, I hereby give my consent for the administration of emergency first aid treatment and/or transfer to an emergency medical facility. I permit the taking of photos and videos of myself and child during program participation for publication in Safety Town's brochure, website, and additional uses as deemed.

Your Signature

Thanks for submitting!