CLC Students Ministry Forms 2025

Helloooo parents!

Welcome to our digital landing spot for all of our CLC Student Ministry forms! (Woohoo)! Our vision at CLC Students is to help students Find Community and Follow Jesus. One tool that we utilize in our effort to do this are our forms (I know, that doesn’t sound too exciting, but hear us out).

These forms help us communicate with you, gather important information, and they help us remain prepared for whatever life may have to throw our way. We do also require that these forms be filled out and submitted in order for students to attend any off-site student ministry events. However, once you fill them out once, you are good for the rest of the year (12/31/25)!

THREE DIFFERENT FORMS
We have three forms (all included below) that we need submitted on behalf of each student (estimated time to complete all forms 15-20 min).

FORM #1- 2025 Health Form: enables us to be prepared in the unexpected event of a medical emergency.
FORM #2 - 2025 Permission Form: this is your chance to learn more about our ministry practices and to let us know that we have your blessing/permission to serve your student(s) in this way!
FORM #3 - 2025 Conduct Covenant: you (and your student) will read and sign this form to get a picture for the culture and the vision that we area all agreeing to pursue together here at CLC Students

ITEMS NEEDED FOR FORMS: We suggest preparing the following items prior to completing these forms:

Have your teenager(s) close-by so that they can read their portion (on the 3rd form)
Have your teenager(s) health insurance information ready (including the contact info of your teenager’s doctor).

We know nobody really likes forms (including Christian), but we sincerely appreciate your commitment to supporting the vision and mission of the Student Ministry here at the CLC. As always, if you have any questions, you can find our contact info below!

Christian Hesling, Studenth Ministry Director (Christian@clcfamily.church)

All forms expire on December 31st, 2025 at 11:59PM.

Your name *

Email address *

Phone number *

FORM #1 - 2025 Student Ministry Health Form (Expiration: 12.31.2025)

This form is in place to gather some information so that we can be prepared in the unexpected event of a medical emergency.

INSTRUCTIONS: Please thoroughly read through the form below and fill in all of the required fields.

Student Profile

Please fill in the following fields regarding your teenager. Select the "Add child" option below. If you are submitting forms on behalf of multiple children, you can add them all here.

Student's First Name *

Student's Last Name *

Student's Gender *

Student's Birthday *

Student's Grade *

Student's School *

Student's Address *

Student's Cell Phone (if applicable)

Second Guardian/Parent & Secondary Non-Parental Emergency Contact

Please fill in the following fields regarding a second parent/guardian and a secondary emergency contact. Should we not be able to reach you (the primary contact) in the unexpected event of an emergency, we would reach out to these individuals.

Second Parent / Guardian Name, Phone, Email

Please include a name, phone number, and email address.

Non-Parental Emergency Contact Name & Contact Number *

What is their relationship to the student? *

Medical Emergency Information

Please fill out the following fields so that we may be prepared in the unexpected event of a medical emergency.

Name of Family Doctor *

Phone Number of Family Doctor *

Medical Insurance Company *

Contract/Policy Number *

List any medications to which he/she is allergic.

List any current medical problems or medicines.

I understand and agree to the statement below. *

I understand that if any of the above information is to change after my submitting of this form, I am responsible for sending in updated information promptly prior to my child(ren)'s participation in student ministry events and gatherings.

Parent/Legal Guardian Initials - to complete this form, please submit your initials below. *

I hereby proclaim that all of the information provided above is accurate to the best of my knowledge and I agree to take responsibility to update any information with the CLC staff that may change during the year. By submitting my initials below, I am agreeing to this statement and agree to the permissions outlined above. (Insert Initials Below)

FORM #2 - 2025 Student Ministry Permission Form (Expiration: 12.31.25)

This form is in place so that we can communicate some of our ministry practices to you and so that you can give us your permission/blessing to serve your students in these ways!

INSTRUCTIONS: Please thoroughly read through the form below and be sure to mark the check boxes to indicate that you both understand and agree to such inquiries/requests.

PROGRAM AND EVENT EXPECTATIONS: I understand and agree to the below statement. *

I understand that the Student Ministry of the Christian Life Center and its staff are committed to providing safe, fun, and educational activities, and that all CLC Student Ministry activities are conducted in a smoke, alcohol, and drug-free environment. In light of this, and to help ensure the safety of all concerned, I understand that if my child is in possession of drugs, alcohol or tobacco products, engages in any illegal conduct, or refuses to acknowledge or oblige to our expectations, disciplinary measures according to the best judgement of the CLC staff and student ministry team will be taken to uphold the safety and security of all parties involved. We will also call the parent/legal guardian to pick-up their child.

TRANSPORTATION PERMISSION: I understand and agree to the below statement. *

The undersigned does also hereby give permission for my child to ride in any vehicle driven by an approved and licensed adult chaperone (21 years of age or older) while attending and participating in activities sponsored by the Student Ministry of the CLC. My child and I understand that seat belts must be worn at all times during transportation.

PHOTO PERMISSION: I understand and agree to the below statement. *

During Student Ministry events, staff or volunteers will occasionally take photos or video of youth participating in various activities. These images may be used by the student ministry of the CLC for online, social media, and/or print publications. Youth will not be identified by name in publications. Checking the box below indicates your permission for our to engage in such practices.

COMMUNICATION PERMISSION: I understand and agree to the below statement. *

A part of the practice of the student ministry is connecting with and supporting students outside of our usual programs. With that, we request permission for your child’s small group leader(s)/CLC Student Ministry staff to communicate with your child via text message (or Instagram if text message is not an accessible medium) for the purpose of checking in, communicating about CLC Students related events/gatherings, and things of the liking. We do not permit our leaders to communicate with our students outside of these two mediums (text messaging and Instagram).

EARLY RETURN HOME POLICY: I understand and agree to the below statement. *

Should it be necessary for my child to return home due to medical reasons, disciplinary action or otherwise, the undersigned shall assume all transportation costs and responsibility.

PERMISSION TO PARTICIPATE IN EVENTS/PROGRAMS: *

The undersigned does hereby give permission for my child (“Participant”) to attend and participate in any CLC Student Ministry activities, events, retreats, during the period of January 1, 2025 to December 31, 2025. To indicate your approval/permission, please enter your child’s first and last name below:

LIABILITY RELEASE: I understand and agree to the below statement. *

In consideration of the student’s participation in the CLC Student Ministry and other ministries (including Sunday Worship, Wednesday Gatherings (COW), Misc. Activities, Events, Retreats, Lock-In’s, Trips, etc.) I, the undersigned, do hereby release, forever discharge and agree to hold harmless the Christian Life Center, its elders, pastors, directors, employees, volunteers, and teachers (collectively herein the “church”) from any and all liability, claims, or demands from accidental personal injury, sickness, or death, as well as property damage and expenses of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in the youth activities. I the parent or legal guardian of this Participant hereby grant my permission for the Participant to participate fully in student ministry activities, including trips away from the church premises. Furthermore, I, on behalf of my minor Participant, hereby assume all risk of accidental personal injury, sickness, death, damage, and expense as a result of participation in recreation and work activities involved therein.

Parent/Legal Guardian Initials - to complete this form, please submit your initials below. *

I hereby proclaim that I understand and agree to the permissions outlined above. By submitting my initials below, I am agreeing to this statement and agree to the permissions outlined above. (Insert Initials Below)

FORM #3 - 2025 Conduct Covenant (Expires 12.31.2025)

This form is in place so that you (and your teenager(s)) can get a picture for the culture and the vision that we area all agreeing to pursue together here at CLC Students.!

INSTRUCTIONS: Please thoroughly read through the Conduct Covenant form (pictured below) and be sure to have you (and your teenager) sign below indicating both your understanding and agreement to this covenant that we will all pursue together!

Conduct Covenant

The following guidelines are in place to uphold the above mission statement of CLC Student Ministry:

• I claim full responsibility for my own behavior and I will participate fully in all scheduled activities of any event; this means, in part, that I will always be at the appropriate place(s) at the appropriate time(s) on trips and retreats.
• I will respect and obey the authority of all the adult leaders and the youth staff.
• I will treat the church facilities (CLC & other churches) with utmost dignity and respect.
• I will treat others (youth and adults), as well as myself with the utmost respect and love; this includes respecting physical and emotional well-being of all by respecting the need for sleep and refraining from harmful practical jokes.
• I will follow all the rules and regulations of the trips/retreats; this includes rules/regulations of the facilities, as well as the particular rules/regulations established by the Student Ministries, both of which will be clearly defined and explained.
• I will put away my phone (and other electronic devices) when instructed to do so to ensure that I myself (and others around me) are not distracted.
• I will use my words for the purpose of edifying and not tearing others down; this includes not gossiping, not using vulgar language, and not speaking down upon anyone.
• I will strive for unity with any and all people(s) and if there is conflict, I will communicate with the youth leader(s) in place to ensure that it is handled in a healthy and constructive manner.
• I will dress in a manner that is respectable to myself and others and does not cause distractions in any way. I will trust the discretion of the youth leader(s) when it comes to determining whether or not one’s appearance is distracting.
• I will not engage in inappropriate sexual behavior.
• For the sake of limiting distractions, I will not engage in the public displaying of affection (PDA); this includes but is not limited to kissing, cuddling, holding hands, and anything that is deemed by the youth leader(s) as PDA.
• I will not participate in any illegal activities, which include, but are not limited to, vandalism, theft, and the use of alcohol, drugs, and tobacco products.
• I will actively pursue an environment that upholds the above values and mission of the ministry and I will strive to hold my peers accountable to do the same.

Parent/Legal Guardian - initial below to indicate that you understand and agree with the terms of the covenant listed above. *

I, the parent/legal guardian, hereby proclaim that I understand and agree to the conduct covenant (pictured above) and will do my best to pursue and uphold the vision of the Student Ministry of the CLC.

Student - initial below to indicate that you understand and agree with the terms of the covenant listed above. *

I, the student, hereby proclaim that I understand and agree to the conduct covenant (pictured above) and will do my best to pursue and uphold the vision of the Student Ministry of the CLC.

Conclusion

Please sign (with your typed signature) and date below.

Signature *

I, the undersigned, hereby proclaim that all of the information provided above is accurate to the best of my knowledge. By providing my signature, I am agreeing to all of the aforementioned permissions, policies, and the liking.

Today's Date: *

Thank you!

That is all! You're done. Thanks a million for spending some time on this. We appreciate your time in this matter and look forward to journeying alongside you and your family!

Peace,
Christian Hesling

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