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Life Church

Location

2200 Sheridan Rd.

Noblesville, IN 46061

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Contact Trevor Fannin:

317-938-3021

trevor@lifechurchin.com

First, Tell Us About Yourself:

Parent Information

Welcome to the Truth 2026! We are so excited for this 2 day event on Saturday October 3 and Sunday October 4! We believe this will be an impactful 2 days of teens drawing nearer to Jesus! Please be sure to reach out to your Campus NextGen Pastor or Pastor Trevor, Director of NextGen ministries (trevor@lifechurchin.com) if you have any questions or concerns!

First Name

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Last Name

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Address 1

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Address 2

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City

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State/Province

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ZIP/Postal Code

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Country

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Contact Phone 1

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Contact Phone 2

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Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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Name of church student regularly attends.

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If regularly attended church is Life Church, which campus does your student mostly attend?

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Click here for your FREE Notes from Jesus Bundle

By checking the box you will be emailed your Free Notes From Jesus Bundle.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Tell Us About Your Participant

First Name

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Last Name

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Current Grade

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Gender

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Date Of Birth

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Shirt Size

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Allergies

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Medical Concerns

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Physical, Mental, or Social Conditions which need monitored

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How should we respond to any conditions?

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Although we encourage students to attend the entire weekend event, we have one day options if necessary for your student to attend. Please let us know when your student will attend.

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Students will be placed into Breakout Groups. Do you have any friends you'd like to be placed with? (Placement requests not guaranteed, although we'll do our best!)

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Friend 2 First Name

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Friend 2 Last Name

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Friend 3 First Name

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Friend 3 Last Name

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Comments

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MEDICAL CONSENT AND RELEASE: I, the undersigned, have legal custody of the student named above, a minor, and have given my consent for my student to attend events being organized by Life Church Assembly of God, Inc. (“Church”). The Church includes its Pastors, employees, agents, and volunteer workers. I understand and consent that my student may be taught Biblical principles.

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* Medical Consent: If my student experiences a medical situation, and I or my emergency contact cannot be reached, I give my permission to seek whatever medical attention is deemed necessary by the Church, and transport my student by ambulance or private vehicle to the nearest medical facility. In the event that my student is injured and requires medical services, I consent to any medical treatment as deemed necessary by a licensed physician. I also acknowledge that I will be ultimately responsible for the cost of any medical services should the costs not be reimbursed by any health insurance provider. I release the Church from any and all medical services and costs .

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* Release: I understand that there are inherent risks involved in any ministry or activity, and I hereby release the Church from any and all liability, loss, or damage to person or property that may occur during the course of my student’s involvement. In the event treatment is required from a physician and/or hospital personnel designated by the Church, I agree to hold the Church free and harmless of any and all liability, claims, demands, or suits for damages arising from the giving of such consent.

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*Release: Photography, Image and Filming Waiver: I hereby grant Life Church, it’s directors, employees, volunteers, any participants, photographers, agents, and designees (Collectively “Life Church and any associates”) non-revocable permission to capture my image and likeness in photographs, videotapes, motion pictures, recordings, or any other media (Collectively “Images”. I acknowledge that Life Church, and the photographers have dual ownership and will own such images and further grant them permission to copyright, display, publish, distribute, use, edit, print, and reprint such images in a highly respectable manner honoring God, the student, Life Church, including without limitation to publications, advertisements, brochures, website images, or other electronic displays and transmissions thereof. I understand the rights and limitations of the photographer according to the Photographer Waiver. I further waive any right to inspect or approve the use of the images by Life Church prior to its use. I forever release and hold Life Church harmless from any and all liability arising out of the use of the images in any manner or media whatsoever, and waive any and all claims and causes of action relating to use of the images, including without limitation to claims for invasion of privacy rights or publicity. Parent or Legal Guardian: I hereby certify that I am the parent and/or guardian of a child under the age of 18 years, and I hereby consent that any images (as deemed above) may be used for any purposes set forth in the Authorization and release.

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Student Drivers - I understand that once my student arrives, they are required to stay on site until official dismissal. I also understand that should my student need to leave for any reason. I will provide notification to the event leaders what time they need to leave and what the transportation will look like.

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Parent/Guardian Signature

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