PERMISSION SLIP

I, as Parent or Guardian, Give Permission for _________________________
(Student’s First and Last Name)

To Attend:

Glasgow church’s annual Camp Hebron youth trip!!!

Event Time: Friday, May 1, 2009 to Sunday, May 3, 2009.
(Registration and payments must be completed and turned in by March 21, 2009.)

May 1st we will first be meeting as usual in “The Loft.” At 4pm sharp. At 7pm we will depart to Camp Hebron.

1.Mode of Transportation: Glasgow’s Church Busses.

2.Students will leave from: May 1, 2009 at 7:00 p.m. and arrive at Camp Hebron at 9:30 p.m.

3.Students will return: May 3, 2009 at 10:30 p.m. at the Glasgow church parking lot.

4. Chaperones in Charge: Youth director Cindy Marx, Associate youth director Danielle Rabella, Counselors Mark Johnson, Katy Olverman, Sarah Clerk, Benita Johnson, Rick Marine, and Trisha Holmes.

Descriptions of the Activities are in the schedule. Any activities you do not wish for your child to portray in please describe below:

I do not give parental approval for my child to participate in the following activities:

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

YES NO

Student has permission to travel via Bus
to Camp Hebron. __________

Student has permission to participate in the following
Activities provided in the schedule?__________

I understand that my child will be obliged to abide by the Christian-Based Rules and by the Code of Discipline while participating in this field trip/program.

In the event of serious illness or injury to my child, I expressly consent to the administration of emergency medical care, if in the opinion of attending medical personnel, such action is advisable.

I have read this Permission Slip and understand its terms. I sign it voluntarily and with full knowledge of its significance.

Parent’s/Guardian’s Signature____________________________________________

Relationship to Minor___________________________________________________

Address _____________________________________________________________
StreetApt. #

________________________________________________________________

_________________ _______________ _________
City State Zip Code

Home Telephone #____________________

Cellular Telephone # ____________________

Work Telephone # ____________________

Alt Telephone # _______________________

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