Event Permission Form

Student Permission Form

I, the parent or guardian of the children listed below, do hereby grant permission for these students to participate in the activities hosted on the dates listed below. I also grant permission for my child to attend small group activities that may occur off of church property provided that a notice (digital or in print) is posted two weeks prior to the small group event occurring.

I understand that Maywood's child policies and procedures will be followed and I acknowledge that I have submitted a Medical Release Form, providing information to be used in the event any medical decisions need to be made.

Date	Activity	Location
January 14-17	Nexus Winterfest	Silver Birch Ranch, White Lake, WI
January 29th	Unplugged Event	Location: TBD
March 19th	Unplugged Event	Location: TBD
April 23rd	Unplugged Event	Location: TBD

Parent / Guardian Name

Primary Phone

Email Address

Today's Date

Emergency Contact

Emergency Phone

Child 1 Name

Child 2 Name

Child 3 Name

Child 4 Name

Child 5 Name

Becoming a People to Reach People for Christ

Student Permission Form

Date

Activity

Location