Permission Slip for All Off-Campus Activities

Youth Permission Slip for All Off-Campus Activities

REGISTRATION FORM

(One per YOUTH)

NAME: AGE:

GRADE IN NOW:

STREET ADDRESS: CITY:

STATE: ZIP CODE:

HOME TELEPHONE NUMBER:

EMAIL ADDRESS:

PARENT/GUARDIAN NAME(S):

CELL PHONE NUMBER(S):

PEOPLE AUTHORIZED TO PICK UP THE YOUTH:

NAME:

CONTACT NUMBER:

RELATIONSHIP TO CHILD:

IN CASE OF EMERGENCY CONTACT (other than parent):

NAME:

CONTACT NUMBER

ALLERGIES OR OTHER MEDICAL CONDITIONS?

PARENT/GUARDIAN SIGNATURE: ___________________________________________________________

**These slips must signed for EACH AND EVERY off-campus event. Once you have filled out one of these initially, each sequential form please fill out youth name, phone information, pick up information and signature.