Good Shepherd Youth Ministries

 

 

I hereby give permission for my child _________________________ to ride with the staff and volunteers of Church of the Good Shepherd to attend

 

Event Name _______________________________

 

Event Dates ______________ to _______________

 

In the event of an emergency, if neither I nor the alternate Emergency Contact can be reached, I give my permission for the adults in charge to authorize emergency medical treatment.

 

 

 

_________________________________                  ________________

Parent/Guardian Signature                                            Date

 

 

_________________________________                _________________________________

Parent/Guardian Printed Name                                   Phone number during event  

 

 

_________________________________                _________________________________  

Alternate Emergency Contact                                      Phone for emergency contact