Shine Student Ministries – Permission Slip

Parental Consent

Onset Christmas Party

Child Name *

First

Last Name *

Last

Parent Name *

First

Parent last Name *

Last

Parent Email *

Parent Phone Number *

Emergency Contact Number *

I hereby grant permission for my child to participate in the activity of the Grace Assembly of God Church Group. Grace Assembly of God Church is not responsible for any medical charges should injury/illness occur.

Parental Consent for Child *

Yes, I provide consent

No, I do not provide consent