Youth Conference -

BOXING FOR CHRIST 4th Youth conference

Registration form

Parent/guardian consent for participation

Child's name

Parent/Guardian Phone

In the event of an emergency if you are unable to reach me, contact:

Emergency Contact

Relation

Phone

PARENT/GUARDIAN CONSENT FOR PARTICIPATION:
I hereby request and consent that my child , may be permitted to
attend and participate in the programs and activities of the Boxing for Christ youth Conference” on
October.17,2026 at the Boxing for Christ gym ( Sallee Park Building 180 Idyllwild dr. San Jacinto, Ca )
I do hereby hold harmless Boxing for Christ, its directors, officers, and volunteers, and the sponsoring
agencies, their officials, divisions and agencies against all liability, damage, loss, claims or demands that
arise out of or are in any way connected with my child or ward’s participation in the conference.
I grant permission for my child to appear in person or in voice, video
or photographic presentation for media reports and/or future publicity campaign(s) resulting from
participation in the conference, and also to complete confidential or anonymous surveys for evaluation
purposes.

MEDICAL CONSENT:
I understand that medical personnel will not be available at the conference. I hereby authorize
conference staff to obtain medical care for my child or ward in the event of a medical emergency,
including making arrangements for special transportation (i.e., by ambulance), should conference staff
be unable to reach me in a timely manner. I understand that I am financially responsible for the medical
care given.