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Highland Youth

(Youth Ministry of Highland Mennonite Brethren Church)
4018 Centre B St NW Calgary AB  T2K 0W2
(403) 276-9396

www.highlandchurch.ca/youth

Dear Parents and Caregivers,

With in-person gatherings of Highland Youth not possible during the current COVID-19 pandemic, we are getting together on-line - on a weekly basis - via the Zoom video-conferencing platform. Since on-line gatherings of minors are considered ministry activities of elevated risk, Highland Mennonite Brethren Church ("HMBC") requires your informed consent via the attached waiver prior to your youth's participation. Once you’ve reviewed the details below and are in agreement with your youth’s participation, please sign the waiver and submit it. If your youth does not already have an Annual Registration and Release Form on file with HMBC, we will contact you to complete this required step as well.

Ministry Activity of Elevated Risk - Highland Youth On-line

Date of Ministry Activity – Fridays at 7 p.m., starting April 3, 2020 and for the duration of the COVID-19 restrictions for gatherings

Purpose - Friendship, Fun, Faith-building Activities

Specifics – Youth in Grades 7-12 are gathering via the Zoom video-conferencing platform in order to hang out, play games, do Bible study, and pray together.

Additional Information

  • Highland Youth on-line will be facilitated by a Highland Youth Leader, using the HMBC-operated Zoom account;
  • the ratio of Highland Youth Leaders to Youth shall comply with established ratios in HMBC's Plan to Protect ® Policy, with a minimum of two (2) Highland Youth Leaders present for the duration of Highland Youth On-line;
  • all Highland Youth Leaders have been fully screened according to HMBC’s Plan to Protect® Policy;
  • youth may only participate if a parent has opted-in on the Waiver
  • youth may only use a webcam if a parent has opted-in on the Waiver;
  • Highland Youth On-line is not permanently open to facilitate chat rooms and Youth will not be able to join outside pre-set times.

Associated Risks include but are not limited to – risks associated with spending time on-line

If you have any questions, please don't hesitate to contact Jenah Park, NextGen Director, youth@highlandchurch.ca

Liability Release

I understand that I am exposing my Youth to inherent risks and hazards. I accept all these risks and hazards and agree that by allowing their participation, I take responsibility for any injury or other loss which may occur during their participation in this HMBC-sponsored Ministry Activity. I undertake and agree to indemnify and hold harmless the Canadian Conference of Mennonite Brethren Churches, The Alberta Conference of Mennonite Brethren Churches, and Highland Mennonite Brethren Church, each of their leadership, staff, and volunteers from and against any loss, damage or injury suffered by my Youth as a result of participating in this HMBC-sponsored Ministry Activity.

Purposes and Extent

HMBC collects and retains this information for the purposes of having written consent for your Youth’s participation in the named Ministry Activity of elevated risk. Upon review and any required follow-up, the original document is filed indefinitely – upon recommendation by our insurance company and legal counsel - in HMBC’s CONFIDENTIAL archives. The information collected is also stored in a password-protected database. The information is accessible only to the Ministry Team Leader, Designated Screening Personnel, Leadership Team, and where required by law. If you wish to limit the information collected, or to view your Child, Youth, or Vulnerable Adult’s information, please contact HMBC.

Today's Date: May 28, 2020

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*

Phone*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*

Phone*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*

Phone*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*

Phone*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*

Phone*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*

Phone*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*

Phone*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*

Phone*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*

Phone*
Tenth Participant's Date of Birth*
Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Caregiver's Email Address

Email*

Confirm Email*
Check to receive Highland Youth news by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Answers apply to all Minor Participants listed in this Waiver
I have been informed of the details of "Highland Youth On-line" taking place on Fridays at 7 p.m., starting April 3, 2020.*
No
Yes
I authorize the participation of my youth in "Highland Youth On-line."*
No
Yes
I authorize my youth to use a webcam while participating in "Highland Youth On-line."*
No
Yes
I understand that I may revoke this informed consent in writing at any time.*
No
Yes
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Caregiver's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Caregiver's Date of Birth*
I certify that I am 18 years of age or older
Parent or Caregiver's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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