Parents, if your youth does not have a permission form on file, or if your youth would like to bring a friend, just print this form out and bring it along to the event!

Youth Group Permission Slip And Emergency Contact Information Program Year: 2008 - 2009

Youth Name ________________________________________________

Parent/Guardian Name ___________________________________________________

Address______________________________________________________

City_________________________ Zip Code_____________

Phone Number (home)___________ (work)____________ (cell) __________

In case of emergency, who else may we contact if we are unable to reach the parent/guardian listed above?

Name__________________________________________________________________

Relationship_____________________________________________________________

Phone Number (home) ____________ (work) __________ (cell) __________

Liability Release:  I give my youth permission to attend Fruitland Evangelical Covenant Church’s youth programs, both on site and off site and hereby release Fruitland Evangelical Covenant Church from responsibility of personal injury.

Signature of parent/guardian________________________________ Date____________