STUDENT MEDICINAL CARE PACKET

Every school year, parents and students are required to submit a new SAP (Student Activity Packet) before participating in any Student Ministry event or activity. - If there are medicine needs, medicine must be handled and left with an adult leader. This form must be accurately filled out by parent/guardian.



This packets contains the following:
Behavior Guidelines Form
Permission/Emergency Treatment Medical Form
Every school year, parents and students are required to submit a new SAP (Student Activity Packet) before participating in any Student Ministry event or activity.
-At some events, a medicinal care form may be necessary. 


This packets contains the following:


Medicinal Care Form


QUESTIONS:


When must I turn these in?

We advise LCCYM families to turn this in at the beginning of the calendar year to cover EVERY activity for that year. A completed SAP is required before participation in any activity.


What must I turn in?

1. A completed SAP packet (all forms) signed by both student and parent

2. A current copy of your health insurance card

3. If medication is needed by your child (extra forms required at each event)


How do I register for events?

All registration is done online at https://lifepointechristian.net/students
10 GUIDELINES

   LCCYM Events and activities are intended to provide opportunities for communal spiritual growth, and relationship building with other students and adult leaders. Please view the guidelines listed here as you do the doors to your house. Their purpose is to keep certain things out and provide a more comfortable environment for those inside.

NOTE: Failure to follow the guidelines, or others that are given at the event, may result in the immediate dismissal of the student.
Please select all that apply.
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Please select all that apply.
Student - Section 1
     I, __Student Name, date__ as the student, agree to abide by the guidelines set by LifePointe Christian Church Youth Ministries (LCCYM). I understand that if I choose to ignore or not follow these guidelines I will be susceptible to the consequences imposed by the adult staff or student minister, which may result in my immediate dismissal from the event or activity.
 
 
Parent or Legal Guardian - Section 2
     I, ___Parent Name, Date__, have read and understand the guidelines listed. I understand that noncompliant students will be asked to leave the event or activity regardless of the time, day or night. In the unlikely case of dismissal, I understand that I am responsible to pick up my child or make arrangements to have my child picked up regardless of the time or location of the event or activity. By signing this I acknowledge that I have read the guidelines and agree to pick up my child in the event of his/her dismissal.
 
 
EVENT YEAR: 2023       REVISED: 01/04/22

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How do I register for events?


All registration is done online at https://lifepointechristian.net/students.

Permission, Medicinal Form

A. Medicine Dispersement

During an event/activity where I am not present, I, the undersigned parent or guardian of        child name, date       , a minor, do hereby authorize adult workers with the Student Ministry of LifePointe Christian Church to act on my behalf to consent to provide for the medicinal care of my child named above, as if I were acting for my child. Further, as a parent or guardian of the minor named above, I understand that if possible, phone contact to me will be attempted prior to any treatment. However, in the event that I am unable to be reached and timeliness of diagnosis or treatment is deemed advisable, I do hereby expressly consent that my minor child may receive medicine without the necessity of first notifying me, and do further agree to hold blameless any LifePointe volunteer, leader for rendering such services.
 
 
A. Medicinal Needs

 - accurately share caregiving needs here. 
 
 
 
 
 
 
 
 
 
I,       Parent/Guardian Signature        have read and agreed to the Liability Release, Medicinal Form (section (A) and hold that the Medicinal Needs (B) are truthful and accurate to the best of my knowledge. I agree that should the medicinal information change from what I have provided, I am responsible for updating these forms for the safety and well being of my child. I further agree that these forms shall remain in effect until the next calendar year or until I revoke them in writing.
 
 
Besides assessing any special considerations your child might require during an event/activity, the information you supply on this page can be supplied to a physician or an emergency medical technician in the event of injury or illness. Please provide any additional information you believe would be relevant to an adult tasked with the care of your child.
Check to indicate YES for any that apply to the participant:
Please select all that apply.
Medicine Handover Agreement

I,       Parent/Guardian Signature        have read and agreed to leave the care to the LifePointe Student Ministry, when my child is on trips or at events. I understand that any medication not disclosed of in this form, LifePointe is not responsible for administering to my child. I understand any medication not appropriately handed to an adult leader before departure of a trip is void, and could lead my child to be dismissed from the event, future events.  
 
 
Parent's/Legal Guardian Consent of Form Use Signature

By entering my name below, I'm giving consent for this information to be used by LifePointe Christian Church. And I'm acknowledging the agreement to the terms of this medicinal care form.
 
 
EVENT YEAR: 2023      REVISED: 01/04/22

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Description

Every school year, parents and students are required to submit a new SAP (Student Activity Packet) before participating in any Student Ministry event or activity. - If there are medicine needs, medicine must be handled and left with an adult leader. This form must be accurately filled out by parent/guardian.



This packets contains the following:
Behavior Guidelines Form
Permission/Emergency Treatment Medical Form