In the event of an emergency give the name and phone number of a relative or friend we can contact who will know how to locate parents or legal guardian:
The undersigned (i) is/are the parent(s)/legal guardian of the above-named student, a minor, (the “Student”); and (ii) represent that they have the authority without the consent of any other and without any condition or qualification to execute this permission/authorization on behalf of the Student. Each of the undersigned also acknowledges that this permission/authorization is binding upon him/her.
The Student has the undersigned’s permission during the period indicated above to participate in any youth activity intended for the Student’s age offered or sponsored by the Thornapple Covenant Church (“Thornapple”) through its youth ministry or otherwise. To the extent a separate permission/authorization form is also required by Thornapple for a particular activity (e.g., an out-of-state trip or a high adventure event), the two shall be interpreted as complementing each other to the fullest extent possible. However, in the event there is an ambiguity or contradiction between the two forms, the specific activity permission form will control.
The undersigned represent(s) that the information provided in response to these questions and requests is complete and accurate and that the undersigned will update this form if there has been any material change in the Student or Adult participant’s health or medical condition or in the emergency contact information.
Parent(s)/Guardian Signature for Student Participant under 18 years old
The undersigned (i) is/are the parent(s)/legal guardian of the above-named Student participant, a minor; and (ii) represent that they have the authority without the consent of any other and without any condition or qualification to execute this form on behalf of the Student participant. Each of the undersigned also acknowledges that this permission/authorization is binding upon him/her.
*By entering my name in the text box above, I am providing my digital signature on this form