Sample Online Church Youth Permission Slip

YOUTH PERMISSION SLIP

Please read this slip carefully, fill out completely, sign and return by day of activity. Your child / children MUST have a signed permission slip in order to attend.

Thank you.

Name*

Phone

As parent / guardian of the above named child, I give him / her permission to participate in the activities of "The Church" at The Church youth fellowship. I release the church and its representatives from any liability in the event of an accident enroute, during, or returning from an activity. I also authorize them to obtain any emergency medical attention that may be required during my child’s attendance.

Emergency Phone Number

Alternate Phone Number

Electronic Signature and Acknowledgement

Enter the date and your full name to acknowledge your electronic signature of this document.

Date*

Your Full Name*

SPECIAL MEDICAL NEEDS

Are there any specific or special medical needs that we should be aware of for your child? Please list them below along with any information that could be helpful.

Thank you.

Notes