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Jr. & Sr. Youth Permission Slip
 
             The undersigned hereby requests and gives Trinity Lutheran Church permission to have my child, (child's name)
______________________________, attend (Youth Activity)
______________________________ , on (date)
______________________________ , and with this signed agreement, the undersigned absolves the leaders, Trinity Lutheran Church, and any and all members of its governing boards of any responsibility for the safety, welfare, health and well-being of the child named above, beyond such matters as may be called reasonable care for youth in the custody of a leader and subject to the leader's clear instructions, and assumes personally and exclusively all responsibility and liability for accident, injury, etc., which may occur to the above named youth during the time of the specified activity.
 
NAME OF YOUTH:
________________________________
NAME OF PARENTS:
________________________________
EMERGENCY PHONE NUMBER:
_________________________________
LIST ANY MEDICAL CONCERNS:
______________________________________________________
PARENT SIGNATURE                                               DATE
__________________________________    ___________
__________________________________    ___________
         
Jr. & Sr. Youth Permission Slip
 
            The undersigned hereby requests and gives Trinity Lutheran Church permission to have my child, ______________________________ , attend all monthly Jr. & Sr. Youth Activities for an entire calendar year and with this signed agreement, the undersigned absolves the leaders, Trinity Lutheran Church, and any and all members of its governing boards of any responsibility for the safety, welfare, health and well-being of the child named above, beyond such matters as may be called reasonable care for youth in the custody of a leader and subject to the leader's clear instructions, and assumes personally and exclusively all responsibility and liability for accident, injury, etc., which may occur to the above namedchild during the time of the specified activity. (Specific activities may require extra permission slips.)
 
NAME OF YOUTH:
________________________________
NAME OF PARENTS:
________________________________
EMERGENCY PHONE NUMBER:
_________________________________
LIST ANY MEDICAL CONCERNS:
______________________________________________________
PARENT SIGNATURE                                               DATE
__________________________________   ___________
__________________________________    ___________
__________________________________    ___________
__________________________________ ___________
                       

 

 

 

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Page Last Updated: 9/11/2012 4:01:41 AM

 
Trinity Lutheran Church and School   9858 North Street Reese, Michigan 48757  ph:989-868-9901