Trip Information:
Destination: Western Kentucky (Melber, Paducah, and Mayfield areas)
Dates: Sunday, June 28, 2026 – Friday, July 3, 2026
Transportation: Rented 15-passenger vans
Confidentiality Statement:
All information provided will be kept confidential by the Pastor of Family Ministry, Kelly Schneikart, and will only be shared with Liberty Christian Church (LCC) volunteers on a need-to-know basis to ensure the safety and care of your child.
Designated Staff and Volunteers:
The following individuals are designated as LCC staff and volunteers for this mission trip:
Staff: Kelly Schneikart, Pastor of Family Ministry
Volunteers: Audrey Culver, Kate Grundy, David Hite, Liz Hite, and Kellen Laws
Please provide at least one emergency contact who can be reached if a parent or guardian is unavailable. This person should be someone authorized to make decisions on your behalf if needed.
Parent/Guardian Information
Parent/Legal Guardian Consent
I, the undersigned parent or legal guardian of the participant named above, hereby give permission for my child to participate in this mission trip with Liberty Christian Church (LCC). I understand the nature of the trip and authorize participation in all planned activities, travel, and related events. I agree to hold LCC, its staff, and volunteers harmless from any and all liability, claims, or demands for personal injury, sickness, or death, as well as property damage and any expenses of any nature whatsoever that may be incurred by my child or myself during the trip, including all travel and transportation to and from trip locations.
Transportation Consent & Authorization
I give permission for my child named above to travel with LCC staff and volunteers as part of this mission trip. I understand that transportation will include rented 15 passenger vans for all trip-related travel, including travel to and from the destination and all scheduled activities. I acknowledge that all drivers are selected and approved by LCC leadership and that reasonable care will be taken for participant safety during transportation. I release and hold harmless LCC, its staff, and volunteers from any and all liability, claims, or demands arising from injury, loss, or damage that may occur during transportation associated with this trip.
Medical Treatment Consent
I hereby give permission to the medical personnel selected by LCC staff or volunteers to order x-rays, routine tests, treatment, and necessary transportation for my child named above. In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by LCC staff or volunteers to hospitalize, secure proper treatment for, and to order injection, and/or anesthesia, and/or surgery for my child named above.
Over-The-Counter Medication Permission
I hereby give permission for LCC staff or volunteers to administer approved over-the-counter (OTC) medications to my child named above as needed, according to manufacturer’s instructions and standard dosage guidelines. This may include, but is not limited to, medications such as pain relievers, antihistamines, antacids, and first aid ointments.
By typing my name below, I acknowledge that I have read, understand, and agree to the terms outlined in this document.