GOD IS GOOD MINISTRIES OF DALLAS - CHILD RELEASE FORM - JESUS CAMP
This is my authorization to allow a designated person to drop off or pick up my child. I am the parent and/or guardian of the child listed below. Also, I signed my child's application and filled out the medical history accurately.
CAMPER NAME
First Name
Last Name
PERSON DROPPING OFF CHILD
First Name
Last Name
PERSON PICKING UP CHILD
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Parent or guardian drivers license or government issued ID:
*
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I understand that my signature on this form constitutes a legal digital signature approving application. I understand that I must be a parent or legal guardian if I'm signing for a child under the age of 18. I have read this application and approve. By signing below, I hereby agree to the "ASSUMPTION OF RISK AND RELEASE OF LIABILITY AGREEMENT, AUTHORIZATION FOR MEDICAL TREATMENT OF A MINOR AGREEMENT, MEDICATION AUTHORIZATION AND RELEASE AGREEMENT" including all statements listed on this application. Please add anymore information in the text box below:
Signature
NAME OF PARENT OR GUARDIAN.
First Name
Last Name
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