PERMISSION FORM
Parents:
I give my permission for my son/daughter _________________________________________
to participate in a Chapel Grove Baptist Church Youth activity. My son/daughter and I
understand that the parents chaperoning are in charge, and my son/daughter will follow all
rules set for this activity. If my son/daughter fails to abide by the rules, I understand that I
will be called to pick him or her up from the activity. I understand that transportation will be
provided by youth chaperones. Also, I will not hold Chapel Grove Baptist Church liable in
the event that my son/daughter is injured during the activity.
_____________________________________________Parent/Guardian Signature and Date
______________________________________________________________Phone Number
Youth Participant:
I understand that youth group activities are a privelage and I am to be on my best behavior. If my
behavior becomes a problem for any reason, I could be sent home from the activity early, and/or
not be allowed to participate in future activities.
_____________________________________________Youth Participant Signature and Date
In the event of an emergency and the parents can't be reached, please contact:
Name and Relation_______________________________________________________________
Phone Number:___________________________________________________________________
Parents:
Are you available to chaperone this event?
Yes, plese call me.
No, maybe next time.