Youth Group Off-Campus Event Permission

Youth Group Off-Campus Event Permission Form

Event Name

Child/Youth Name

Street Address

State

Parent's Home Phone

Date of Birth

Select a date

Age

City

Zip Code

Parent's Mobile Phone

Child/Youth Mobile Phone

Parents/Guardians Name:

Address (If different than above)

In case of emergency if not available, please notify:

Home Phone

Street Address

State

Relationship

Mobile Phone

City

Zip Code

Child/Youth Allergies, Prescription Medications or Other Concerns

I give my child permission to attend the Youth Group event

PHOTO REFUSAL: If for any reason you DO NOT want photographs of your son or daughter to be used in our VBS slideshows, or as part of our church or local media, please initial and and date below:

Your Signature

Select a date