YNG Conference Cost: $70

Student Information

Parent Information

Medical Information:

I, the undersigned parent/guardian, grant permission for my son/daughter (the minor child listed below) to attend the above listed event at The Connection Church. I understand that there is always a possibility that my child may sustain physical illness or injury while participating in camp activities. I agree to hold all of the below listed organizations/entities, and individuals or personnel associated with these organizations, harmless from any and all liability, claims and demands which arise or may hereafter arise from above named minor’s involvement in any activity supervised by The Connection Church. Organization/Entity Listing: The Connection Church (TCC); BUDA BLUE HOLDINGS GP INC.; Buda Blue Holdings LP; Ampersand Art Supply. I hereby authorize TCC personnel to make medical decisions which may be necessary in an emergency and, in my absence, for the wellbeing of the minor listed below. I understand that every effort will be made to contact me if my child needs medical treatment. If it is impossible to do so, I give my permission to any TCC personnel to secure proper treatment; to transport, to hospitalize, order injections, anesthetize, x-ray or authorize surgery for the above said minor. I authorize any duly licensed doctor, hospital or other medical facility to treat the below said minor for the purpose of attempting to treat or relieve any injuries received by above said minor while in the care of the TCC personnel. I authorize any licensed physician to perform any procedure which he/she deems advisable in attempting to treat or relieve any injuries or related unhealthy condition above said minor may encounter during any necessary operation. I further acknowledge and understand that I will be responsible for any medical bills/expenses relating to medical treatment provided. I acknowledge and understand that my child will be responsible for his/her behavior and that failure to abide by the rules and regulations may result in removal from the remainder of the event. I hereby consent to and authorize TCC to use my child’s image and likeness in photo or video materials relating to the event for promotional or informational purposes.