Teens For Christ l PO Box 920, Hudson, WI 54016 l 715-386-2549 l www.teens4christ.com
Parent Information
Name) First Name* Last Name* has my permission to take the following over-the-counter medicines for the following reasons:
I hereby give my permission to medical personnel or staff members with proper credentials to give emergency medical treatment and care to the above named program participant and to administer any above-approved medication.