Junior Staff Permission Form Junior Staff Permission Form Applicant Name:(Required) First Last Applicant Age (as of June 1):(Required)Parent/Guardian:(Required) First Last Phone Number:(Required)Email Address:(Required) Relation to Minor:(Required)Signature(Required)I hereby give permission for (name of minor), if accepted to serve on staff, to participate in all activities as a Boardwalk Chapel staff member.Date Signed:(Required) Photo Use Permission(Required)As the parent or legal custodian of (name of minor), I hereby agree to the publishing of photos of my child, which may include any image in connection with his or her participation in the Boardwalk Chapel ministry, with the understanding that such photos will be used solely on the web site, social media, and/or in promotional materials. Photos may include the individuals name and personal information given and approved by the individual.Phone Tracking Permission(Required)As the parent or legal custodian of (name of minor), I hereby acknowledge, and agree, that the Boardwalk Chapel committee members, Director(s), and/or leadership will use cellular phone tracking device and/or application(s) on my child’s cellular phone for the sole purpose of being able to track where said child is located, at all times, for my child’s safety and protection. The tracking of the cellular phone will ensure that the Boardwalk Chapel committee members, Director(s), and/or leadership will know if my child is where he or she should be, as well as to locate my child should he or she become lost, in danger, or found in any location where my child should not be found.Medical Treatment AuthorizationPhysician’s Name:(Required)Phone Number:(Required)Medical Insurance Provider:(Required)Allergies, Medications, or Prescriptions:(Required)Other Notes:(Required)Signature(Required)As parent or legal custodian of (name of minor), I authorize and consent that the Director, Summer House Parents, and other responsible adults serving in leadership at the Boardwalk Chapel be permitted to administer general first aid treatment for minor injuries and illnesses. For severe injuries and illnesses, I authorize said leaders to exercise their best judgment in seeking professional emergency personnel to attend, transport, and treat the minor where he or she may be cared for by a licensed medical professional or institution.Effective(Required)From: To:(Required)To: Date Signed:(Required) To:
