30 Hour-Famine Consent Form

Dear Parent/Legal Guardian,

Your son/daughter has shown an interest in participating in World Vision’s 30-Hour Famine from March 7-8, 2008. Participation means that your son/daughter will:

Sign up 30 Hour Famine sponsors and collect money to help those around the world who suffer from hunger, poverty, and a lack of hope.

Miss three main meals by fasting for 30 hours.

Drink only water and/or juice during those 30 hours.

Participate in service projects located in the Dallas Metroplex area.

If your son/daughter is not physically capable of fasting for 30 hours, he or she can still participate in a modified fast. Fasting is a physical benefit for most people. Exceptions are children under 12 years of age, the elderly, diabetics, those pregnant or nursing, and others who have had recent surgeries or have other specific medical problems. Most youth will have no problems completing the 30 Hour Famine; however, if your child has special nutritional needs, we will have crackers and nuts available. If you have any questions please call or e-mail your youth director.

Thank you,
DCCYC Board


As a parent/legal guardian of , I have reviewed the information about the 30 Hour Famine, and give permission for the subject of this release to be involved in the overall activities.

I/We have reviewed the rules of the activities and agree that the subject of this release will abide them. I/We also acknowledge that if the subject of the release has to return home early for discipline violations, it will be at my/our expense.

I/We understand all reasonable safety precautions will be taken at all times by Dallas Chinese Bible Church, DCCYC, and its agents during the events and activities. I/We authorize any treatment by an accredited hospital and/or physician deemed necessary for the subject of the release in case of an emergency. I/We understand the possibility of unforeseen hazards and know the inherent possibility of risk. I/We agree not to hold Dallas Chinese Bible Church & DCCYC, their leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by the subject of this form.



Parent/Guardian Name (Please Print)



Parent /Guardian Signature Date



Address/City/Zip


(Parent Cell) Phone # (Home) Phone #