“Go For It!” BaseCamp Youth Service Project Permission Slip
I (your name, please print) _________________________, am considered the legal guardian of (child’s name, please print)__________________________. And I hereby give permission to attend the Calvary Chapel Quakertown BaseCamp Youth’s Go For It! Service project on July 19th, 20th and 21st
“Go For It!” is three jam-packed days of BaseCamp Youth’s students and leaders serving others in the local church and surrounding community. It’s going to be awesome! Our theme for “Go For It!” is Matthew 10.
Students are to arrive at CCQ at 9:00am and should plan on being picked up at 8:00pm. We will be working 2 three hour works blocks per day with lunch in between. Please pack your own lunch for the three days. Dinner will be provided. The cost for the three days is $25 a person. ($10 for the T-Shirt and $5 per day that you’ll be attending.)
Please bring the REQUIRED permission slip signed by a parent, and the proper amount of money. Please hand in all money and forms to Luis Toro, Marcos Toro or Chris Vasquez.
I release and hold harmless Calvary Chapel Quakertown and its youth leaders from any and all actions of any nature of personal injury arising from my child’s participation in this activity.
I/We also acknowledge that if the subject of the release has to return home early for discipline violations and/or injury, it will be at my/our expense.
I/We understand all reasonable safety precautions will be taken at all times by Calvary Chapel Quakertown and its agents during the events and activities.
I, therefore grant permission for first aid to be administered, proper treatment and/or hospitalization to be secured for my child in case of emergency according to the best judgment of the youth leaders and other adults on site.
Please list any medical concerns/allergies your child may have, also list any prescription medication he/she may be taking at this time. (If none, please state so):
_________________________________________________________
_________________________________________________________
_________________________________________________________
Parent/Guardian Contact Information:
Home Phone #: ________________________________________
Cellular Phone #: ________________________________________
Alternate contact (name and phone) if you are unavailable:
Name: ___________________________________
Phone #: _________________________________
Signature of parent/guardian __________________________________________
Printed name of parent/guardian ________________________________________
Date ______________________________
