Health & Permission Form (Rev 2023)

Please fill out this form and click submit.
If you would prefer to download a copy and complete by hand, please click here.
Student Information

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Parent Information

Medical Information

Please select all that apply.
Please select all that apply.
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Please select one option.

For Parents:  Activities may include but are not limited to:  Sunday School, Wednesday Night Youth Gatherings, camping, swimming, outside games, sports, other physical activities such as climbing, trampolining, broom-ball, hiking, concerts, and riding a bus.  Note:  If you desire to limit your child’s participation in any event, please submit your wishes in writing to the student minister prior to the event.


The above named student has my permission to participate in all youth activities sponsored by Fannin Terrace Baptist Church.  By signing this consent form, I give permission to staff/volunteers to seek necessary medical attention and release Fannin Terrace Baptist Church and associated staff/volunteers of any liability against personal losses of named child.  As parent/legal guardian of said student, I understand that there are inherent risks involved in any event and I release Fannin Terrace Baptist Church, affiliate churches, it’s pastors, employees, agents and volunteers from any and all liability for any injury, loss or damage to person or property that may occur during the course of my student’s involvement.  I acknowledge that I am ultimately responsible for the cost of any medical care that may be necessary.  I affirm that the health insurance information provided is accurate at this date and will, to the best of my knowledge, still be in force for the student named above.  I agree to bring my child home at my expense should they become ill or if they fail to abide by the following Student Expectations as observed by the pastor or other youth leader.


I also release any pictures or video footage of my child used within the context of Fannin Terrace Baptist Church’s promo/highlight footage/church websites.


By signing, I allow my child to receive appropriate text message, emails, and phone calls, as these are essential to an active youth ministry.  I understand that at any time I may ask for copies of texting or email conversations between my child and any youth leader, as mediated through Fannin Terrace Baptist Church’s Pastor.
Student Expectations

We expect each student to conform to these stanaards of conduct:

No possession or use of alcohol, drugs or tobacco

Respect one another, staff, leaders, and property

No person allowed in the sleeping quarters of the opposite sex

No romantic displays of affection:  kissing, prolonged hugs, etc.

Group participation is expected as is compliance with event schedule

Students are not permitted to drive themselves or others during FTBC sponsored events

No offensive or immodest language or clothing

No fighting, weapons, fireworks, explosives, or lighters permitted

A positive attitude is expected (no whining or complaining)


Students who fail to comply with these expectations may be sent home at parent’s expense.
I have read the above expectations of conduct and agree to abide by them.


Please fill out this form and click submit.