Student Ministry Event Participation Waiver for One Life Church
Parent/guardian consent, medical authorization, and release form for minor participation in church events.
Parent/Guardian Full Name
*
First Name
Last Name
Minor’s Full Name
*
First Name
Last Name
Minor’s Age
*
Parent/Guardian Email Address
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Event Name
*
Event Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Medical Conditions or Allergies (if any)
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Signature
*
Date of Signature
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Church Use Only: Notes
Submit Waiver
Submit Waiver
Should be Empty: