Annual Blanket Permission Form

A separate Permission Form shall be required for any overnight trip or event and any event or trip that requires transportation to a site outside of Cecil County, Maryland or New Castle County, Delaware.

Your name *

Email address *

Permission

Haven Community Church uses a blanket permission slip for off-campus activities for each Church school year. This policy applies to all children and youth in grades six through twelve. This form, along with an annual Youth Registration must be one file for your child or youth to be included in any such events. By submitting this form, I hereby give permission for the child named below to participate with the Haven Community Church children or youth groups, at any and all off-campus, church approved events for the period listed below. I will notify the specific group leaders if my child does not have permission to attend a specific event. I have completed the annual Consent to Medical Treatment Form and it is on file with the Church. I accept responsibility for payment of any and all expenses required for a specific local, off-site event. In submitting this form, I understand that I will hold neither the supervisory adults nor Haven Community Church or any of its agents liable for injuries or damages sustained by my child/youth during any off-campus, Church-sponsored event.

Child's Name *

Authorization Period *

We suggest you select September of this year to September of following year to be consistent with when we ask for updated submissions, but it is up to you given your circumstances. Please provide a START month/year and FINISH month/year.

Parent/Guardian Name *

Parent/Guardian Email *

Parent/Guardian Mobile Phone *

Electronic Signature

By my electronic signature below, I hereby certify and affirm that the information in this form is accurate to the best of my knowledge. I also agree that I will hold harmless Haven Community Church and its agents, employees, the employing or judicial authority or any other entity from any and all claims, liabilities, and causes of action.

Signature *

Today's Date *

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