My child, has my permission to attend the below event.
Please print event name and date:______________________________________________________
I authorize any DBC staff person to treat or seek and authorize any medical attention necessary for my child in my absence.
Known Medical conditions of student: __________________________________________________
Medications of student: __________________________________________________
(All medications will be kept secured by a youth leader, and administered as prescribed on provided documentation)
Phone number where parent or guardian may be reached during event: ____________________________
Name and Phone number of other emergency contact: ________________________________________________
Parent Signature:____________________________________________Date:_________________________
Any payments can be made to: Day Bible Chapel
Please read the below expectations of conduct for this event at below link, and sign below if you agree to them
Signature of Youth: ___________________________________________________________
Please print, have parent or legal gaurdian fill out, and give this completed form to any youth leader.