Kool Christian Ministries: Permission Slip

 

I, __________________________, allow my child, _____________________________, to attend Kool Christian Ministries.  I authorize Joe Quatrone, Lindsay Snell, and other leaders to be caretakers of my child when they are at church meetings, youth group functions, general activities, etc.  I grant Joe, Lindsay, and other leaders permission to drive my child in their vehicles to and from church, to and from functions outside church (mall, movie theater, diner, bowling, etc.), and to and from any other special activity.  I do not hold Joe, Lindsay, and other leaders responsible for any poor choices my child makes, nor do I hold Joe, Lindsay, and other leaders responsible for any accidents that might occur while driving or attending functions.

 

 

Insurance Information

 

Health Insurance Provider: ________________________________________

 

Allergies: _____________________________________________________

 

Further Information: _____________________________________________

 

_____________________________________________________________

 

 

Emergency Contacts

 

1) Name: ___________________________________________________

 

-         Relationship: _______________________________________

 

-         Phone Number: _____________________________________

 

2) Name: ___________________________________________________

 

-         Relationship: ________________________________________

 

-         Phone Number: ______________________________________

 

 

 

* Parent/ Guardian Signature: ________________________________________