Professional Youth and Young Adult Consent and Waiver

Name of Youth/Young Adult*
First Last
Please read the below program policies and sign below acknowledging your receipt and understanding of the agreement, as well as your consent to participate in the Lenox Road Baptist Church Professional Resource Program. If participant is under age 18, this form must be completed by the legal guardian. PROGRAM POLICIES 1. The Professional Resource Program involves Professional Advisors, who shall be screened (via application and criminal background check), selected by the Lenox Road Baptist Church Mentoring Ministry, and oriented before beginning the program. 2. The participant will be expected to spend time with the Professional Advisor on-site at programs/events/meetings held at the church. Support to the participant may also be offered through telecommunication technologies, which may include but are not limited to telephone, mobile devices, interactive videoconferencing, email, chat, text, and Internet (e.g., websites, social media, etc.). 3. The Professional Advisor is not allowed to take or meet the participant outside of the church facility without the separate, written consent of the participant (if over age 18) or legal guardian, in which case the Lenox Road Baptist Church is not held liable. 4. The program does not require the Professional Advisor to update a legal guardian on the progress of the participant or nature of the advisement once the program is underway. The decision about what information to share, if any, will lie with the participant (regardless of age), unless there is a serious safety concern (suspicion of imminent danger), which will then be verbally communicated to the Mentoring Ministry Leader (Rev. Dr. Sharon Downer) and legal guardian or listed emergency contact. 5. The LRBC Mentoring Ministry may take and utilize photographs/videos of Professional Resource Program participants (advisors and advisees) during events at the church for documentation and promotional purposes. The LRBC Mentoring Ministry reserves the right to use any photographs/video and participants waive all rights of compensation based on the signing of this form.
Please read the below program policies and sign below acknowledging your receipt and understanding of the agreement, as well as your consent to participate in the Lenox Road Baptist Church Professional Resource Program. If participant is under age 18, this form must be completed by the legal guardian. PROGRAM POLICIES 1. The Professional Resource Program involves Professional Advisors, who shall be screened (via application and criminal background check), selected by the Lenox Road Baptist Church Mentoring Ministry, and oriented before beginning the program. 2. The participant will be expected to spend time with the Professional Advisor on-site at programs/events/meetings held at the church. Support to the participant may also be offered through telecommunication technologies, which may include but are not limited to telephone, mobile devices, interactive videoconferencing, email, chat, text, and Internet (e.g., websites, social media, etc.). 3. The Professional Advisor is not allowed to take or meet the participant outside of the church facility without the separate, written consent of the participant (if over age 18) or legal guardian, in which case the Lenox Road Baptist Church is not held liable. 4. The program does not require the Professional Advisor to update a legal guardian on the progress of the participant or nature of the advisement once the program is underway. The decision about what information to share, if any, will lie with the participant (regardless of age), unless there is a serious safety concern (suspicion of imminent danger), which will then be verbally communicated to the Mentoring Ministry Leader (Rev. Dr. Sharon Downer) and legal guardian or listed emergency contact. 5. The LRBC Mentoring Ministry may take and utilize photographs/videos of Professional Resource Program participants (advisors and advisees) during events at the church for documentation and promotional purposes. The LRBC Mentoring Ministry reserves the right to use any photographs/video and participants waive all rights of compensation based on the signing of this form.
Signature Page
First Last
Date*
MM slash DD slash YYYY

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