Family Fellowship Church Youth Group (6th-12th Grade)
Permission Form
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
123-456-7890 or 1234567890
Parent/Guardian Email
*
example@example.com
Youth Name
*
First Name
Last Name
Youth age and grade
*
Youth height and weight (For activities that require this information. An estimate is fine)
*
Youth Name
First Name
Last Name
Youth age and grade
Youth height and weight (estimate)
Youth Name
First Name
Last Name
Youth age and grade
Youth height and weight (estimate)
If you have more than 3 children participating please include their names, ages, grade, height, and weight below.
If your child(ren) have any allergies (e.g. food), medical conditions (e.g. asthma), or medication that we should be aware of please list them below. (If you have multiple children please specify which child) If none, please put “none”.
*
In the event that my child(ren) need(s) transportation to an activity, I give permission for a member of the FFC Youth Group team to transport my child(ren))
*
Yes, I give permission for a FFC Youth Group team member to transport my child(ren) to and from activities.
No, I do not give permission for a FFC Youth Group team member to transport my child(ren) to and from activities.
I, undersigned, agree with the following statements:
I am the parent/guardian of the child(ren) stated above.
I voluntarily elect for my child(ren) to participate in the activity with Family Fellowship Church Youth Group.
I hereby confirm that my child is in good physical condition and does not suffer from any disabilities or physical conditions that place him/her or others at risk or otherwise physically inhibit participation in this event.
I herby permit Family Fellowship Church Youth Group and it’s leaders to sign any additional release/waivers on my behalf for the purpose of this activity.
By this waiver and release, I acknowledge that I have read, understand, and fully agree to the terms of this waiver and release and its contents. My signature is proof of my intent to execute a complete and unconditional waiver and release of all liabilities in force under the law.
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature
*
Submit
Should be Empty: