By signing this release form, I hereby grant permission to any Pleasant View Student Ministry Volunteer or any agent of Pleasant View Church to secure emergency medical treatment for my son/daughter and permission to attending physician, medical facility, and staff in the event of illness or injury to my child and release Pleasant View, its staff and officers from responsibility in case of accident, illness, or injury. By checking the box below, I confirm that my typed name will act as a legal signature on this document.

Note: This medical release form is effective for one year from the above date. It can be used any time this child is in the care of Pleasant View Church for any reason.

I give permission for my child to participate in Pleasant View Church youth ministry events during the months of September 2026-August 2027. In addition, I hereby agree to hold harmless the church or any person in its organization for the result of any neglegent , willful, or intentional acts of my child which requires repair and/or reimbursement of expenses. Further, authorization and permission are given to Pleasant View Church to furnish the above participant with any necessary food and transportation to, from, and during any event. While my child is attending an event, I understand and accept that Pleasant View Church will provide supervision. In the event of sickness or injury to my child I assume responsibility for all medical bills, if any occur.

Please initial below if you do NOT give permission for Pleasant View Student Ministry to post pictures of your child on our social media sites.