25 K PERMISSION SLIP - ACTS 
THIS FORM MUCT BE COMPLETE BY PARENT OR GUARDIAN IF PARTICIPANT IS A MINOR

IF PARTICIPANT IS AN ADULT, PLEASE FILL OUT AND MARK "NA" IN AREAS NOT APPLICALBE 
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NAME OF STUDENT / NOMBRE DEL ESTUDIANTE: *
NAME OF PARENT - GUARDIAN / NOMBRE DEL PADRE/TUTOR LEGAL: *
PARENT PHONE NUMBER / NUMERO DEL TELEFON DE PARE *
As the parent/guardian of the above named student, I give permission for my child to participate in the field trip described below:

Como padre/tutor del estudiante arriba mencionado, otorgo el permiso para que mi hijo(a) participe en el paseo que se describe a continuación:
 *
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NAME OF PARISH / NOMBRE DE PARROQUIA: ACTS YOUTH MINISTRY 
ACTS YOUTH MINISTRY IS A MINISTRY OF ST. PATRICK / ST RICHARD AND ST. EDWARD
DATE OF EVENT / FECHA DE EVENTO: JULY 7, 9AM,  25K BIKE RIDE FROM ST RICHARD 1509 GRAND AVE
DESTINATON / DESTINO: FROM ST RICHARD TO PIKE BIKE TRAIL
DESIGNATED TEACHER OR SUPERVISOR / MAESTRO O SUPERVISOR DESIGNADO: ELOY CONTRERAS (262) 664-3111
Mode of Transportation/ Modo de transportacion: BIKE
DEPARTURE TIME / HORA DE PARTIDA: 9AM
RETURN TIME / HORA DE REGRESO: 1PM
STUDENT COST / COSTO PARA EL ESTUDIANTE:  NONE
PLEASE COMPLETE FORM AND RETURN BY / PLEASE COMPLETE FORM AND RETURN BY: JULY 6
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