Join us every Sunday and Wednesday!

Calvary Chapel Sonora’s High School Ministry meets on Sundays at 9:30 am and on Wednesdays at 5:00 pm for a time of
worship, teaching, games and fellowship.

Learn more

Connect. Grow Together.

-Upcoming Events-

Medical Release Form

Please complete a medical release form prior to youth participation at an event with CCS.

High School Release

Student's Name

First Name

Last Name

Phone

(###)

###

####

Birthdate

MM

DD

YYYY

Email Address

Signature of Parent or Guardian

(Please Read Carefully & Fill Out Completely) I hereby give my permission for my son/daughter to participate in youth activities organized and/or led by the youth ministry of Calvary Chapel Sonora. As the legal parent/guardian of the above, I assume all and full responsibility and liability for any illnesses, disease, infirmity or alteration in physical condition sustained by any person for any reason whatsoever. I hereby release Calvary Chapel Sonora, its employees and its officers (including those ‘drivers’ helping in the transportation of students in an activity) from any and all responsibility and liability in case of illness, accident, injury, or death, and authorize any medical care deemed necessary by an accredited physician, nurse, paramedic or hospital while involved in the aforementioned activity. In the event of illness, accident or injury while the student is in the care of Calvary Chapel Sonora, I understand and agree that I am financially responsible for any care provided. In the event that it becomes necessary or advisable for any reason whatsoever to alter the itinerary or arrangements, the leadership reserves the right to make such alterations. I understand that I will be required to pick-up that aforementioned student at the leadership’s request if the participant’s behavior is contrary to the spirit and intent of this activity. The signing of this form by the parent or legal guardian shall be consent to the above conditions.

Date Signed

MM

DD

YYYY

Physician's Name

We do not anticipate any problems, however, your student may be treated by a physician without parental authorization. Naturally, you will be called immediately if we do have any problems, but there is always the possibility that promptness in treatment may be necessary. This is not said to alarm you, but to make you aware that your child will be protected in every way possible. Please list below any pertinent information that might concern your child’s health, such as allergies, drugs, chronic ailments or disorders, etc.

First Name

Last Name

Physician's Phone

(###)

###

####

Parent/Guardian Phone

(###)

###

####

Cell Phone

(###)

###

####

Emergency Contact (Name/Relation)

Medical Insurance

I.D. #

Any Allergies? (Including Medications)

Is Your Child Taking Any Medications?

Chronic Medical Conditions?

Social Media Permission

** On occasion we like to post pictures of our events on Social Media. Our intention is to keep families and the church involved in our fellowship. Are images of your child allowed to be used on Social Media during/after this event?

Yes

No

Parent/Guardian Signature