Junior Youth Permission Slip

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

3rd - 6th grade

Name(s) of all Youth Attending *

Parent / Guardian Name *

Emergency Contact Number(s). Please include at least 2 *

Name of Event and Date *

Do you grant permission for your child to attend the above event sponsored by Poplar Ridge Friends? *

Yes

I have read the following release and liability statement and agree.

I hereby release Poplar Ridge Friends Meeting and any and all adult sponsors or church staff from any liability in the event of an accident in route, during, and returning from the sponsored event. Should emergency medical treatment be necessary, I authorize Tim Vestal or any other adult sponsor of the event to act on my behalf and approve appropriate treatment. I further grant permission for any photographs or videos taken at this event of my child(ren) to be used for any lawful purposes in connection with the promotion and activities of Poplar Ridge Friends Meeting.

Yes

Other:

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Poplar Ridge Friends Meeting. Report Abuse

Forms