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Permission Slip
The minor child listed below has my permission to participate in the trip to: KING & COUNTRY CONCERT | AUGUST 18TH 2022 with Vineyard Youth Group
By Signing this digial form I authorize Vineyard Christian Fellowship to consent to any treatment and/or hospital care deemed advisable by a physician for the above-named minor child, or myself, in the event a parent or guardian cannot be reached to authorize such treatment or care. I also give my permission for them to call an ambulance, or take the above-named child, or myself, to an available physician or medical treatment facility.
Any Known Allergies (for none put n/a)
Medications your child is taking (for none put n/a)
Medical Conditions:
Medical Insurance Carrier
Policy Number
Emergency Contact:
Relationship to Child:
Your Signature
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Select a date
Relationship of Signer to Child:
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