Medical Liability and Photo Release:

I, the undersigned, being the parent or legal guardian of the child named above (hereinafter “the child”), do hereby consent to my child's participation in all of ROX Youth and Roxborough Church ministry events for the year January 2026 through December 2026. This includes activities both on and offsite, including but not limited to mission trips, retreats, and trips. Further, I certify that my child is physically fit to participate in these activities. I also understand that I will be notified in the case of any medical emergency involving my child. However, if I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services if my child is injured or becomes ill. I understand neither ROX Youth nor Roxborough Church ministry, nor ministry staff is held responsible for medical expenses incurred, but that such expenses will be my responsibility as parent/guardian. I, also grant permission to The ROX Youth Ministry or Roxborough Church to publish pictures & videos of myself and/or the minor named above on Ministry websites, in promotional videos, press releases, or any other form of public publicity.

Statement of Rules and Expectations:
I also understand that all participants are expected to adhere to the following rules,
1. No use or possession of tobacco products, alcohol, or illegal drugs.
2. No use of inappropriate language will be permitted.
3. Cell phone use will be limited.
4. No leaving activity locations without permission from a leader.
5. Inappropriate displays of affection will not be permitted.
6. No disrespect to the adult leaders or other students will be tolerated.

I have completed the above, and have read these rules and understand that if there are any discipline problems with my child, that I am responsible for picking up my child from any activity of ROX Youth at any time and location necessary.