EC YTH Annual Student Permission/Medical Form '25
Please complete a form for EACH of your students participating in activities in Evangel Church.  These will be kept on file for emergency contact/medical information.  
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Child FIRST name: *
Child LAST name: *
date of birth *
MM
/
DD
/
YYYY
Parent Name: *
Parent Phone: *
Please List TWO emergency contacts: *
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