Fuel Gladiators Permission Slip

Published on March 2018 | Categories: Documents | Downloads: 35 | Comments: 0 | Views: 165
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Name ________________________________________________________________________________ Address ______________________________________________________________________________ City, St, Zip _____________________________________ Phone _____________________________        Email ______________________@__________________

Fuel Gladiators PERMISSION SLIP I give permission for _________________________________ to participate in the Fuel Gladiators  events/activities.  I understand that the Fuel Gladiators activities may occur on the Central Assembly of  God premises or off the premises.  I am giving permission for my child(ren), named on this form, to  participate in any and/all Fuel Gladiators Events/Activities occurring on Wednesday nights Fall of 2009.  In  an emergency, I hereby consent to a licensed physician selected by Fuel staff to hospitalize or secure  proper treatment for the child named on this form.  I will not hold Fuel/Central Assembly of God liable  for any injuries occurred on this trip. ______________________________________________________   Parent/Guardian Signature  Emergency Number Insurance Information Company Name ____________________       Policy Number  __________________ Current  Meds ________________________________________________________  Allergies ____________________________________________________________

Fuel Students 2445 S Lincoln Rd  Mt Pleasant, MI 48858 989.773.2221

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