Encephalitis • Scarlet Fever • Whooping Cough • Autism/Asperger's • Tires Easily • Fractures • Convulsions • Epilepsy • Asthma • Fainting Spells • Frequent Headaches • Eye Problems • Dizziness • Rubella • Chicken Pox • Ear Problems • Frequent Urination • Frequent Colds • Nosebleeds
Please note that for the safety of all event participants, all medications (including over-the-counter medications) will be held and administered by the designated Health Supervisor. The non-prescription medications listed below (or their equivalents) will be available and provided for the corresponding symptoms. Please do not send these meds with your child (with the exception of Epi-pens).
Liquid Maalox for abdominal pain • Chlortrimaton, Benedryl for allergy, hives and bites • Maalox for nausea • Pedialite for vomiting • Adrenaline for asthmatic attack or acute allergic reaction to insect bites • Auralgan (if not allergic to –caines), Sinutab and Afrin for earache • Imodium for diarrhea • Milk of Magnesia for constipation • Ibuprofen, Acetaminophen for fever, flu, headache and menstrual cramps • Solarcaine (if not allergic to –caines), Ibuprofen for sunburn • Ibuprofen for muscle spasm • Sinutab for sinusitis • Robitussin DM for cough • Hibaclens and Polysporin for cuts • Cortaid Cream for rash
We are legally required to get parent/guardian opt-in on each section of the permissions & releases.
Required for participants under age 18
I, the parent or legal guardian of this registrant, hereby give permission for my child to attend this event. I agree that, should my child commit a serious infraction of NCNC rules, I will arrange to remove my child from the event at the request of the youth director or conference staff at the earliest possible opportunity. I understand that I am responsible for my child’s transportation to and from the event under the supervision of an adult over 21 years of age who has written permission to transport my child.
Really!? You don't want your kid to go to Annual Gathering after getting this far in filling out the form? The required signature field below will not appear until you consent to allow your child to attend.
I will not send my child to Annual Gathering if he/she has been ill within the two weeks prior to the youth event. NCNC will grant a full refund when presented with a doctor’s note.
In case of medical emergency, I give permission to the physician selected by the Director, Health Supervisor or other authorized event staff member to secure proper treatment for, hospitalize and order injection, anesthesia or surgery for my child. I also give permission to the aforementioned staff member(s) to provide/arrange appropriate transportation (e.g., ambulance, designated staff member) for my child to receive medical services.
Your child cannot attend Annual Gathering unless you consent to their medical treatment in an emergency. The required signature field below will not appear until you consent to emergency medical treatment.
I hereby give permission for my above named child to go swimming, participate in the free gym, and other optional activities at the Sonoma State University Recreation Center. This is offered as a voluntary option during the Northern California Nevada Conference UCC Annual Gathering Youth Program. Understanding that every effort will be made to reduce the risks involved in this activity, I hereby release and hold blameless NCNC UCC and youth leaders. I understand that a signed waiver is also required by Sonoma State University.
I hereby give my consent for NCNC UCC to use any of the photographs taken of my child, named above, at this event for publicity, such as for future brochures or other materials designed to inform potential participants or user groups about Annual Gathering Events. With consent I hereby release the NCNC UCC from any claim whatsoever that may arise in said regard. I understand that the above named youth will participate if an all-youth photograph is taken.
YOUTH EVENT COVENANT
All participants are required to sign the covenant – youth and adults. If you break the covenant, you may be required to complete a Process of Reconciliation to participate in future conference youth events. If needed, youth can sign this Covenant on-site at Annual Gathering. Parents should read this covenant and understand the expectations while at the event.