AfterHours Student Release Form
Thanks for stopping by!

This is our Student Release Form.

Before participating in Redeemer's Student Ministry activities, each student must have a release on file. The release guarantees that in the event of an emergency, employees and our leadership team can contact a parent, guardian, or emergency contact, or, if necessary, secure emergency medical attention as required. This release must be completed by an adult parent or guardian, once for each child. If you have any questions or concerns, please contact Corey Garrity, Minister to Youth and Young Adults, at
Email address *
Student Name: *
Your answer
Parent/Guardian Name: *
Your answer
Parent/Guardian Email Address: *
Your answer
Participation Release
Release of Liability
Emergency Medical Treatment Release
Transportation Release
Publicity and Marketing Release
Parent Guardian Data
Parent Name *
Your answer
Parent Guardian Phone *
Your answer
Student Information
Grade: *
Your answer
Birthday: *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service