PARENT/LEGAL GUARDIAN TRAVEL CONSENT FORM

Please complete the form below . Each Youth will be required to have a form completed for each event and have it submitted in advance of the event.

NOTE: Submission of this form will serve as a consent/waiver form in replacement of signing a physical copy of the waiver. If you prefer to read and submit a printable copy click here.

Destination/Event

Date of Departure

YYYY

Time

Hour

Minute

Second

Date of Return

YYYY

Time

Hour

Minute

Second

Parent/Guardian Name

First Name

Last Name

Phone

(###)

###

####

Parent2/Alternate Emergency Contact

First Name

Last Name

Phone

(###)

###

####

Participants

Child 1

First Name

Last Name

Allergies/Special Needs

Child 2

First Name

Last Name

Allergies/Special Needs

Child 3

First Name

Last Name

Allergies/Special Needs

I understand that this digital form is considered the same as physically signing the waiver found at the link at the top or bottom of the page, and by typing my name it serves a my signature.

Yes

No - If selecting this option, then please print and sign the physical form

Type Parent/Guardian Name Here

NOTE: Submission of this form will serve as a consent/waiver form in replacement of signing a physical copy of the waiver. If you prefer to read and submit a printable copy click here.

PARENT/LEGAL GUARDIAN TRAVEL CONSENT FORM

Please complete the form below . Each Youth will be required to have a form completed for each event and have it submitted in advance of the event.

Millarville Community Church