Collage (18-26) | G3 Conference 2026

Parent/Legal Guardian Name First and Last *

Parent/Guardian Phone Number *

Emergency Contact *

Name of Student/Young Adult First and Last *

Age *

Would you like to be placed with a friend if so please state who? *

List any known allergies and medication that will be taken on this trip. *

I understand that participation in activities hosted by Grace Harvest Church, including conferences, concerts, worship services, transportation, lodging, and related events, involves inherent risks that may result in injury, illness, property damage, or other loss.

I voluntarily assume all risks, known and unknown, associated with participation in this trip.

I hereby release, waive, discharge, and hold harmless Grace Harvest Church, its pastors, staff, volunteers, leaders, members, and representatives from any and all liability, claims, demands, or causes of action of any kind, whether arising from negligence or otherwise, including but not limited to injury, illness, medical conditions, emotional distress, property damage, or death.

I understand that Grace Harvest Church does not provide medical or accident insurance, and I am responsible for any medical expenses incurred.

MEDICAL AUTHORIZATION

In the event of an emergency, I authorize Grace Harvest Church and its representatives to obtain medical treatment for me (or my child) if deemed necessary. I authorize any licensed physician or medical facility to provide care if emergency contact cannot be reached.

I accept full financial responsibility for any medical treatment provided.

PHOTO & VIDEO RELEASE

I grant permission for Grace Harvest Church to use photographs or video recordings taken during the event for ministry, promotional, or educational purposes.

Full Legal Name (Typing your name acts as your electronic signature) *

Date *

I confirm that I am the parent or legal guardian of the participant. *

Check Box

I have read, understand, and agree to the Liability Waiver and Medical Authorization above. *

Check Box

Parent/Legal Guardian full name (For any minors under 18) *