Student Permission Form
Students will be riding in a vehicle with their pre-determined team and driver, to take pictures of Christmas decorations around town. This form must be filled out in addition to the team registration form. Student will be expected to arrive at 501 B street by 6:30 pm. Teams will NOT wait for late team members.
Student Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Has your Student already been registered on a team?
*
Please Select
Yes
No
Driver
*
First Name
Last Name
Because my student is a "Free Agent" and not affiliated with a team I understand the following:
*
Filling out this form does NOT guarantee my child can participate in the above event.
Spaces will be filled on a first come, first placed basis.
In the event that no openings are available, my child will remain at the church for the duration of the event, where alternative activities will be provided.
I, the parent/guardian of the student named above, agree with the following statements:
*
I hereby give permission for my child to take part in the trip described above.
I give permission for my child to ride in a vehicle with the above named/assigned driver for their team.
I understand that my child is expected to behave responsibly.
I understand that students who act in an inappropriate or unsafe manner may be excluded in the future from ministry activites.
I agree and understand that I am responsible for the actions of my child, and I release the church from all claims and liabilities that arise in connection with the trip.
I agree that in the event of an emergency injury or illness, the staff member(s) in charge of the trip may act on my behalf and at my expense in obtaining medical treatment for my child.
Parent/Guardian Name:
*
First Name
Last Name
Phone Number
*
Email
*
example@example.com
Signature of Parent/Guardian
*
Submit
Should be Empty: