JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Medical Release Form & Waiver
To be filled out by a parent or guardian.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Student Name (First & Last)
*
Your answer
Parent/Guardian Name(s) (First & Last)
*
Your answer
Home Address (City, State, Zip code)
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
2020-2021 School Grade
*
Your answer
Gender
*
Female
Male
Student T-Shirt Size (Adult Sizing)
*
S
M
L
XL
XXL
Next
Page 1 of 4
Clear form
Never submit passwords through Google Forms.
This form was created inside of First United Methodist Church of Howell.
Report Abuse
Forms
