Transporation and Attendance Permission Form

New Heights Baptist Church

Transportation and Attendance Permission Form
I, Parent/Guardian Name * give consent for the following child(ren) listed below to ride the New Heights Baptist Church van, bus or any other vehicle, to and from church services or any other church sponsored events.
Child's Name*

First NameLast NameAllergiesBirthdateGrade
Child's Name

First NameLast NameAllergiesBirthdateGrade
Child's Name

First NameLast NameAllergiesBirthdateGrade
Child's Name

First NameLast NameAllergiesBirthdateGrade
Parent / Guardian Name*

First NameLast NamePhone Number
Parent / Guardian Name

First NameLast NamePhone Number
Emergency Contact

Allowed to p/u child(ren) from church?First NameLast NamePhone Number
Address*

Street Address

Mailing if Different

CityState

Zip Code
I grant permission for New Heights Baptist Church, its officers, workers, volunteers, or any other representative to act on my behalf in the event of an accident or injury to my child(ren) provided reasonable effort has been made to reach me.Initial*
I agree to hold New Heights Baptist Church, its officers, workers, volunteers, or any other representative guiltless in the event of an accident or injury to my child(ren). Initial*
Moreover, I understand and agree that New Heights Baptist Church, its officers, workers, volunteers, or any other representative will NOT be responsible to administer or to store medications of any sort for my child(ren). Initial*
New Heights Baptist Church has a NO electronic device policy which INCLUDES the usage of cell phones unless communicating with parents. Your child(ren) MUST ask before using. I understand and agree to the NO electronic device policy.
Initial
By signing below, I affirm that I am the parent or legal guardian of the child(ren) listed above and agree with the terms and conditions set forth by New Heights Baptist Church.
Signature*

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New Heights Baptist Church