FPCLG Permission Form for
Grades 6-12

This online form will serve as your registration for and explicit permission for your children to participate in all activities and outings with the children’s and youth ministry programs of the First Presbyterian Church of La Grange (FPCLG) during the 2025-2026 program year. These include, but are not limited to, Cross Trainers (Grades 6-8), Confirmation, TUXIS (Grades 9-12) and Church League Basketball (Grades 9-12). Outings may include travel by bus or car with adult supervisors.

*Denotes Required Field

Name of Participant

First Name

Last Name

Grade in School

Participant's Cell Phone (if applicable)

(###)

###

####

Participant's Email (if applicable)

Allergies or other pertinent medical information

Name of Additional Participant

First Name

Last Name

Grade in School

Participant's Cell Phone (if applicable)

(###)

###

####

Participant's Email (if applicable)

Allergies or other pertinent medical information

Name of Additional Participant

First Name

Last Name

Grade in School

Participant's Cell Phone (if applicable)

(###)

###

####

Participant's Email (if applicable)

Allergies or other pertinent medical information

PARENT/GUARDIAN INFORMATION

Parent/Guardian's Name

First Name

Last Name

Parent/Guardian Cell Phone

(###)

###

####

Parent/Guardian Phone (other)

(###)

###

####

Parent/Guardian Email

Additional Parent/Guardian Email

Emergency Contact Name

Please provide contact information for a second parent or other responsible party we may contact if we cannot reach the parent/guardian listed above.

Emergency Contact Cell Phone

(###)

###

####

Emergency Contact Phone (other)

(###)

###

####

Who can (or cannot) pick up your child?

Volunteers are the heart of our ministries, and we couldn't do it without you! Would you be willing to volunteer?

List areas or capacities in which you'd prefer to volunteer.

For example, Preschool, Faith Forest, Cross Trainers (Grades 6-8), TUXIS (High School), outings? As a leader, assistant, chaperone?

Consent to Receive Text Communications

Texting may be used to coordinate activities and communicate event details to youth in grades 6-12. Any texts sent to youth will have the parent or an additional Trained Adult Leader included in the correspondence.

FPCLG staff and advisors may communicate with my teen via text, if applicable, as described above.

Photo Release

I hereby give permission for the above named participant(s) to be photographed during children's and youth ministry events. I understand that these untagged photos may appear in newsletters, on the FPCLG website and/or on FPCLG Facebook and Instagram and that children and youth will NOT be named in any photo posted on the FPCLG website or on social media.

PARENT/GUARDIAN PERMISSION (participants 18 and over may consent on their own behalf)

By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions. The above-named participant(s) has/have my permission to engage in the events described above. In consideration of the benefits derived from participation, I hereby voluntarily waive any claim against First Presbyterian Church, La Grange, Illinois 60525, or its staff or advisors for any and all causes that may arise in connection with this activity. In case of serious accident or illness emergency, we hereby give permission to the adult advisors to secure proper treatment for our children as named above.

I ACCEPT

Date

YYYY

Signed

Please type the full name of one parent or guardian to electronically sign this document and agree to its terms. Participants 18 years of age and over may sign for themselves.

FPCLG Permission Form for Grades 6-12

Location and Contact Info

FPCLG Permission Form for
Grades 6-12