Microsoft Famine Permission Forms

30 Hour Famine 2009 Guidelines and Expectations Below you will find a list of the rules that are to be followed while participating in the 30 Hour Famine. These are in place to help ensure the safety and well being of each participant. We ask that you, the parent/legal guardian and your teen sign the bottom of this slip as a statement that you both understand and plan on adhering to these expectations. 1) Each youth must follow the guidelines set forth by the leaders at the beginning of the Famine. 2) Listening to and being respectful of your chaperones is of the utmost importance, as we will maintain a level of trust and respect with you as well. 3) There will be absolutely NO possession or use of alcohol, tobacco products, or drugs while participating in this event, or we will be forced to send you home immediately! We reserve the right to check anyone’s bags for these products and or for weapons, should suspicion arise. 4) No one is allowed in a sleeping room of the opposite sex at any time!

Because we feel that these rules are important in making the 30 Hour Famine safe and fun for everyone, the breaking of these will result in consequences. These will range from a warning, loss of privileges, and possibly being sent home in the worst of scenarios. Parent’s Signature: ___________________________Date:_______ Teen’s Signature: ____________________________Date:________

Permission and Medical Release Form Baker Memorial United Methodist Youth Group Name: _________________________________________ Phone #: (______)__________________ Address:_______________________________________ City, State, Zip: __________________________________ Grade: _________________ Age: ___________________ I give my permission for my above named child to participate with the Baker Memorial United Methodist Youth Group during the 30 Hour Famine 2009, taking place March 27th and March 28th, 2009 at Baker Memorial UMC. I understand that this event includes participation in a 30 Hour fast from solid foods. I also understand that fasting for 30 Hours is recommended for children over the age of 12 due to safety concerns. I understand that my child will also be participating in service projects throughout the community and may be transported in a chaperone’s vehicle. I hereby release Baker Memorial United Methodist Church, its staff, sponsors, and volunteer leaders from responsibility and liability for any injury or illness that my child may sustain during this activity. In the event of an emergency, I hereby authorize an adult leader for this activity (J.L. Miller, Heidi Miller, Jeff Thompson, Katie Felton), as agent for me to consent to any x-ray examination; medical, dental, or surgical diagnosis; treatment; and hospital care advised and supervised by a physician, surgeon or dentist (as appropriate) licensed to practice under the laws of the state where the services are rendered, either at a doctor’s office or at any hospital. I expect to be contacted as soon as possible. Signature of parent or legal guardian: ____________________________ Date: ______________ Home Phone #: _________________________ Cell Phone#:____________________________ Emergency Contact, Name and #:___________________________