Student Medical Release Form

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All students in grades 7th-12th must complete this form in order to participate in off-campus events with Matthew Road.

Email *

This form will cover the following student events in the 2024 year, January 1 - December 31:

- Pizza + Outreach events

- Super Bowl Watch Party

- Girls Conference (There4Gathering)

- Guys Conference (Reality Conference)

- Spring Break Service Week

- Boulder Adventure

- VBS Week Hangout

- Idaho Mission Trip (additional forms required)

- Swim Parties

- Youth Camp (additional forms required)

- Fall Kick Off

- High School Football Games

- Saturdays in September (Girls)

- Worship @ the Lake Nights

- Fall Outing

- Fall Retreat @ Mt. Lebanon (additional forms required)

I agree that this form authorizes my student(s) to participate in all the above listed events

Required

Parent Name
*

Parent Phone Number
*

Parent Email
*

Address *

Street Address, City, State, and Zip

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