Permission Slip For Youth Online

Each participant needs a permission slip. You may print the form and fill it out or submit it online.

Activity:*
Date of activity:*
Name of youth:*
FirstLast
Address*
Street AddressAddress Line 2CityZip / Postal Code
Parent/Guardian Permission*
As the custodial parent/guardian, I hereby give my prmission for: (name of youth)
To attend the FUMC Youth: (name of activity)*
on: (date of activity)*
I give my consent for my child to be transported to and from the event with the adult leaders. (parent's name)*
Medical Release*
My child is in good health. In case of medical emergency, I give my permission for the Adult Leaders of the FUMC Youth Group to secure treatment for, hospitalize, and order any medical procedures deemed necessary for the health of my child. (name of child)
Date*
Signature of parent/guardian*
Phone numbers where you can be reached. Home #*
Work Phone
Cell Phone
Your Email*
Enter EmailConfirm Email
Name*
Other emergency contact: (In case we can't reach you>)
FirstLast
Phone number for other emergency contact: (In case we can't reach you.)*
Relationship of other emergency contact to you.*