Carowinds Parent Permission Form
Grace Education & Youth Ministries are so excited to host this trip to Carowinds for our children. The trip will be Saturday, August 10, 2024. Please complete the registration and consent form below. PLEASE SUBMIT ONE FORM PER CHILD. This form must be completed and received to secure your child's spot on the trip. If you have any questions, please reach out to our Education ministry leaders at education@graceu.org or our Youth Ministry Administrator at danielle@graceu.org.
Contact Information
Child's Name
*
First Name
Last Name
Parent's Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Parent Consent
Departure Date and Time:
Saturday, August 10, 2024 6:00AM
Return Date and Time:
Saturday, August 10, 2024 10:00PM
Destination Address:
Carowinds Amusement Park - 14523 Carowinds Blvd., Charlotte, NC 28277
Medical Information
Please provide the information requested below as it may be needed in case of an emergency.
Child's Date of Birth
*
-
Month
-
Day
Year
Date
Allergies:
Conditions requiring special consideration (medical/physical):
Does your child require any of the following? Select all that apply:
Epipen
Inhaler
Does your child require any other medications that we should be aware of? If so, please explain below.
Emergency Contact #1
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Relationship to Child
*
Emergency Contact #2
First Name
Last Name
Phone Number
Please enter a valid phone number.
Relationship to child
Medical Consent
Parent's Signature
*
Date Signed
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: