Church Van Pickup Permission & Liability Release
Authorize our church to transport your child and acknowledge release of liability.
Child's Full Name
*
First Name
Last Name
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Liability Release Agreement
*
By signing below, I give permission for my child to be transported by the church van and release the church from any liability.
*
Submit Permission
Submit Permission
Should be Empty: