Meridian Assembly of God

Meridian Assembly Event Permission & Medical Information

I hereby give permission for my child

(child under 18 years of age) to be with and in the care of Meridian Assembly’s Youth and/or Young Adult pastor, and Youth and/or Young Adult leaders for the Summer Fellowship Intensive Scavenger Hunt.

It is understood that my child will be transported by bus, van, car or other pre-determined method of transportation and will stay in pre-determined lodging (if applicable). I hereby grant permission for such transportation and lodging.

Agenda:
June 19^th:

12:45PM: Depart from Meridian Assembly to The Village
1:00PM: Scavenger Hunt at The Village at Meridian
3:45PM: Return to Meridian Assembly

*Please pick your student up at Meridian Assembly no later than 10AM.

EVENT & MEDICAL PERMISSION

By my signature below, as parent or guardian, I hereby give permission or release my child to attend this event sponsored by Meridian Assembly Youth Ministries on the date specified below. Permission is also given to use photographs (individual or group) and/or multimedia images and recordings in the best interest of Meridian Assembly. Concerning transportation, I will arrange for my child to be dropped off and picked up at the times specified above. It is understood that my child will be transported by bus, van, car or other pre-determined method of transportation and will stay in pre-determined lodging (if applicable). I hereby grant permission for such transportation and lodging.

In the event that my child becomes ill or sustains an injury while in the care of Meridian Assembly, I wish to be contacted promptly. If I am unavailable, I give permission to those in charge of my child to take whatever steps necessary to administer emergency first-aid. I further give my permission and authorize my child to receive emergency medical/surgical care as deemed necessary by any duly licensed physician/practitioner, to administer treatment required for the relief of pain and preserve his/her life and health.
Name: Signature: Date
Phone ALT:

Event Permission Slip

Revised 05/03/2017