Parent Consent & Bus Rider Agreement Form

Gethsemane Church Children's and Bus Ministry

600 State St. • Pekin, IL

Dear Parent/Guardian,

We are thankful for your interest in Gethsemane Church's Children's Ministry and/or the Bus Ministry. Our goal is to provide a safe, orderly, and Christ-honoring environment for all children, including those who ride our bus to and from church services and ministry activities.

Please carefully review the following requirements with your child:

Behavior Expectations

Your child is expected to be respectful in class and on the bus at all times. Good listening and appropriate behavior are necessary to maintain a safe and respectful environment.

Disciplinary measures for ignoring rules are as follows:

1. First Warning: Verbal reprimand
2. Second Warning: Meeting with Pastor Noyes
3. Third Warning: Two-week suspension from class

Cleanliness Policy

To help keep the bus clean, no food or drinks are allowed on the bus.

Cell Phone Policy

Cell phones and electronic devices may be used only in an emergency and are expected to be silenced or turned off during all services.

Photo, Video & Media Release

I understand that photographs and video recordings may be taken during Gethsemane Church services, classes, activities, and transportation ministries. I grant permission for Gethsemane Church to use photographs, video recordings, and audio recordings that may include my child for church-related purposes, including but not limited to the church website, church Facebook and social media pages, printed materials and promotional items, church presentations, and ministry publications.

I understand that no compensation will be provided for the use of such photographs or recordings. I release Gethsemane Church, its staff, volunteers, and representatives from any liability associated with the use of these images and recordings.

YES, by signing, I give permission for my child to be photographed and/or recorded.

Bus Ministry Guidelines

• Pickup Time: Children should be ready between 5:45 PM and 6:45 PM.
• Preparedness: Children must be dressed and have shoes on, with porch lights on for both pickup and drop-off.
• Health: If your child is sick or contagious, please have them stay home.
• Pickup/Drop-off Location: Children will be picked up and dropped off at the same location, and parents can only confirm pickup for their own children.
• Supervision: An adult must be present at drop-off to receive the child.
• Transportation Responsibility: If a parent/guardian chooses to drop off their child, they are also responsible for picking them up.
• Absence: If you have confirmed that your child is attending but plans have changed, please notify Zelma at 309-642-4327 as soon as possible.

Emergency Contact Information

Please provide two emergency contacts:

Child Information

Medical Authorization & Emergency Treatment Consent

Does your child have any allergies, medical conditions, medications, or special needs that our staff should be aware of?

In the event of an emergency and I cannot be reached, I authorize Gethsemane Church staff, bus workers, and volunteers to obtain emergency medical treatment for my child as deemed necessary. I understand that every reasonable effort will be made to contact me or my emergency contacts before treatment is administered.

Acknowledgment & Signature

I have read every word carefully and understand the requirements and expectations of the Gethsemane Church Children's and Bus Ministry. I agree to ensure my child follows these guidelines. I also grant permission for emergency medical treatment as stated above and acknowledge my media release.

I give permission for my child to attend Gethsemane Church services, classes, activities, and transportation provided by the Gethsemane Church Bus Ministry.

Thank you for helping us maintain a safe and enjoyable ministry for all children!

Sincerely, Gethsemane Church Bus Ministry Team