2024 Summer Mission Trip: Explore Madison
Mission trip registration form and permission slip for July 15-17, 2024
Sign in to Google to save your progress. Learn more
Name of Youth
Birth date of youth
MM
/
DD
/
YYYY
Grade of Youth in Fall 2024
Clear selection
Name of School
Name of Parent or Guardian
Parent/Guardian Phone/Cell Number
Parent/Guardian Email Address
Youth Email Address
Home Address (Number and Street)
City, State, Zip
Please list any allergies or dietary restrictions
Do you consent for your child to be included in photos of Messiah events that may appear on the Messiah website and social media platforms?
Clear selection
As the parent or guardian of the person listed above, I give permission for my child to attend, be transported to and from preconfirmation/confirmation and youth program events including service projects, and youth night activities, and participate in activities related to these events. In the event that my child may require medical attention, I expect that reasonable efforts will be made to contact me; however, permission is granted for the leaders of the event to seek emergency medical attention for my child. I also understand that participation in any Confirmation program or activity is a privilege. If for any reason my child violates that privilege, I agree to come or make the necessary arrangements for my child to be picked up. IF YOU AGREE, PLEASE TYPE YOUR NAME and today's date below.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy