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.This once-a-year “red tape” enables us to provide safety and care for your child and ensure that we have current contact information for you.
This packets contains the following:
Behavior Guidelines Form
Permission/Emergency Treatment Medical Form
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?
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.
• Swimwear for ladies - one piece suits, full coverage (we understand these are difficult, but not impossible to find), dark t-shirt tops are equally acceptable.
• Swimwear for guys - must fit properly around the waist (no oversized, sagging shorts), no Speedos.
• No extremes in dress will be permitted such as plunging necklines, bare midriffs, short shorts or skirts (mid-thigh is appropriate), immodest tight apparel, yoga pants, shirts with inappropriate words and/or slogans, sagging pants.
• Ladies tops must have straps at least 2” wide. No spaghetti straps, halter tops or strapless.
At the discretion of the LifePointe staff or sponsors, a student may be asked to cover up or change his/her clothing. If these standards seem extreme, understand that we don’t mind extremes to avoid distraction or accidental “over-exposure.”
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.
Parent, Guardian Contact Information is Required for all trips.
The above email address will be used to send event information, packing lists, balance due statements, deadline reminders, etc.
Permission, Liability Release & Emergency Medical Treatment Form
A. Liability Release and Permission Form
I, the undersigned parent or guardian of childs name, date below , a minor, do hereby give permission for my above named child to participate in one or more of LifePointe Christian Church Youth Ministries’ events/activities, which may include life groups, off-site service projects, out of town trips, hiking, swimming, camping and transportation by car, van or bus.
Furthermore, I give LifePointe Christian Church permission to publish, distribute, and promote any photograph, videotape or sound recording produced by the Church (its Student Minister, ministerial staff, elders, deacons, adult volunteers/sponsors) and authorize any printed material or social media posting by the Church in connection therewith. I release all claims against the Church with respect to copyright ownership, publication and right to privacy.
In consideration for allowing my child to participate in an event, I agree to release LifePointe Christian Church (and/or its Student Minister, and/or their trustees, ministerial staff, elders, deacons, adult volunteers/sponsors) from any and all liability associated with the activity. Additionally, I do hereby release and discharge LifePointe from all claims, obligations, damages or demands for personal injury, sickness or death, as well as property damage and expenses of any nature whatsoever which may be incurred by the undersigned and their child listed above.
B. Emergency Medical Treatment
In the event of an emergency 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 complete medical 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 emergency medical treatment from any physician, hospital, or other medical center without the necessity of first notifying me, and do further agree to hold blameless any physician, hospital or other medical center for rendering such services.
I, Parent/Guardian Signature have read and agreed to the Liability Release and Permission Form (section A), and the Emergency Medical Treatment(section B) and hold that the Medical Information (section C) is truthful and accurate to the best of my knowledge. I agree that should the medical/insurance 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 school 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.
EMERGENCY CONTACT: People to be contacted in case of injury or illness:
Check to indicate YES for any that apply to the participant:
Sections 10-17 are optional, and are to be filled out at the discernment of the Parents and Guardians of the student.
These sections will better help LifePointe's Staff, Volunteers serve the needs of your child.
If not filled out, LifePointe is to not be held responsible for medical needs listed in sections 10-17.
18. I have included a copy, front and back, of my child’s current health insurance card. I agree that the above information about my child's health is truthful and accurate.
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 medical release form.