5th-8th Grade HOG Day @ Noah's Ark 2021

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Permission Slip & Parent Contact Digital Sign-up Form

Event Details

Place: Noah’s Ark: 1410 Wisconsin Dells Pkwy, Wisconsin Dells, WI 53965
Date: Tuesday, July 13th
Time: Bus leaves FRC Oostburg at 7:00am, we’ll be back around 9:30pm
Chaperone: Toby Thomack & Justin Oliver
Transportation: Church bus & Coach Bus
Cost: $40 which covers: ticket, transportation, & lunch
Bring: Bag supper (we’ll have coolers), Swim wear, towel, sunscreen, change of clothes.
Due Date: This digital consent form & money (checks: FRC Oostburg) are due Wed., July 1st

Student's Last Name *

Student's First Name *

Student's Date of Birth *

YYYY

Address *

Name of Parent or legal guardian to contact in case of emergency *

Emergency Contact Phone Number *

If the above person cannot be contacted, what is the name of the next person who should be notified in case of emergency *

Backup Emergency Contact Phone Number *

Please list any medical conditions or allergies *

As a parent/legal guardian of the student listed above, I have reviewed the information about the youth ministry activity/event and give my permission for the subject of this release to be involved in the overall activities of this event. *

Parent/Guardian Digital Signature - In typing my name I am giving my digital signature that the information provided is true to the best of my knowledge *

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