Youth Event Permission Slip

    *Today's Date:(If your browser does not support a calendar picker. Date must be entered manually in YYYY-MM-DD format (e.g. 2019-12-25)

    I give permission for to attend

    from to .

    Self AdministeredSupervision/Help Needed

    I understand that I will be notified in the case of a medical emergency involving my son/daughter. However, in the event I cannot be reached, I authorize providing necessary medical services in the event my child is injured or becomes ill. I authorize a representative of Seaport Community Church including paid and volunteer staff to make emergency medical care decisions on behalf of my son/daughter, if required by law or a health care provider. I understand that the Church will not be responsible for medical expenses incurred solely on the basis of this authorization.

    By signing below, you agree to all statements above and agree that your son/daughter is medically cleared and has your permission to participate in all activities associated with the event.

    *Parent Signature:
    *Cell Phone Number:


    *Emergency Contact Name:
    *Contact Number:
    Emergency Contact Name:
    Contact Number: