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TFC Connection TFC Connection

Health Form

Here you can fill out your health form in order to go to larger TFC events like ice skating, camp, SPLASH, and mission trip! If you’ve already filled out a form in May, then you won’t need another until the next May! The current active health form is from May 2022 - May 2023.

2023-2024 Health Form


Please read and agree to the following

  • On this , I/we the parent(s)/legal guardian(s) of the above-named child ("Participant") do hereby delegate to the TFC Connection Staff a "Power of Attorney" for the above-named child for the purpose of having custody of my/our child and my/our consent to any needed emergency/medical treatment and administration of prescribed medications of my/our child.
  • In the event that I cannot be reached in an emergency during the dates specified on this form, I hereby give my permission to the physician or dentist selected by the TFC Connection Staff to hospitalize, to secure proper treatment, and/or order any injection, anesthesia, or surgery for my son or daughter as deemed necessary.
  • I understand that every activity sponsored by TFC Connection is carefully planned and adequately supervised by mature adults. However, even with the best planning and precaution, unforeseen events can occur. By signing this form as parent/guardian, I/we agree to assume and accept all risks and hazards inherent in ministry-related activities and events. I/we acknowledge that participation in TFC Connection ministry activities and events involves risk to the participant (and to the participant's parents or guardians, if the participant is a minor), and may result in various types of injury including, but not limited to, the following: sickness, exposure to infectious/communicable disease, bodily injury, death, emotional injury, personal injury, property damage, and financial damage.
  • In consideration for the opportunity to participate in TFC Connection activities and events, the participant (or parent/guardian if the participant is a minor) acknowledges and accepts the risks of injury associated with participation in and transportation to and from the activities or events. The participant (or parent/guardian) accepts personal financial responsibility for any injury or other loss sustained during the activity or event, or during transportation to and from the activity or event, as well as for any medical treatment rendered to the participant that is authorized by the sponsor or its agents, employees, volunteers, or any other representatives (collectively referred to as the "activity sponsor"). Further, the participant (or parent/guardian) releases and promises to indemnify, defend, and hold harmless the activity sponsor for any injury arising directly or indirectly out of ministry activities and events, or transportation to and from activities and events, whether such injury arises out of the negligence of the activity sponsor, the participant, or otherwise.
  • I/we also agree not to hold TFC Connection, it's employees or volunteer assistants liable for damages, losses, or injuries to the participant or their personal property. As parent/guardian, I understand that I am signing for the minor named on this form and the signatures are to provide for the medical release and the liability release.
  • Further, should it be necessary for the participant to return home due to medical reasons, disciplinary action, or otherwise, I/we hereby assume transportation costs for their return.
  • I give permission to TFC Connection to use my child's image in photos or videos taken at TFC sponsored activities and events in order to publicize or promote TFC activities, including promotional materials, the TFC website, and social media pages.



    • What medication schedule do you follow?

    Medication must be in it's original labeled container from the pharmacy


    You have not agreed to the liability release. Please have a guardian read and agree to it first.
    You have not entered in your insurance name.
    You have not entered in a policy number.
    You have not included a copy of your insurance card.
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