707/Rock Winter Weekend Release Form 2023
Name of student attending Winter Weekend
*
First Name
Last Name
Which ministry does your student attend?
The ROCK (Middle School)
707 (High School)
Are there any physical/mental/dietary restrictions that we should be aware of?
Insurance Company
*
Insurance Policy#
*
Under Name Of:
*
Relationship to student :
*
OPC MILFORD Staff is allowed to give my student over the counter medications for minor ailments.
*
Yes
No
Oak Pointe Church Participation Release
*
*
*
Parent/Guardian Info
*
Parent/ Guardian Signature
*
Clear
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
-
Area Code
Phone Number
Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty:
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