Permission Slip

Choose the Event Sponsor

SECTION 1

(If applicant is under 18 both sections must be filled out.)

I/we hereby agree that

NAME

has our permission to participate in the

Title of Event

By signing this I/we have received, read, and agree that he/she is expected to obey and respect those in authority regarding policies and rules pertaining to this trip.

Type Participants Name Here - electronic signature

Type Parent/Guardian's Signature Here - electronic signature

Type the Date Here

You Must Check this Box to Confirm Signature

Confirm Signature

SECTION 2

LIABILITY RELEASE

(All applicants must fill this section out)

I/we hereby release the the Heights International Ministries, South Canonsburg Church, Evangelization Society or the Church at the Heights, its ministers, employees, and volunteer assistants from any and all liability whatsoever arising out of any injury, damage, or loss which may be sustained by said person during the course of involvement with HIM,SCC ES and/or the CATH. I/we release the Heights International Ministries, South Canonsburg Church, Evangelization Society or the Church at the Heights its ministers, employees, and volunteer assistants from any and all liability whatsoever arising from any violation of laws, statutes, or ordinances by said person during the course of involvement with the Heights International Ministries, South Canonsburg Church, Evangelization Society or the Church at the Heights.

Permission to use my child's picture in publication of this event on social media

Give Permission

Do Not Give Permission

Type Participants Name Here - electronic signature

Type Parent/Guardian's Signature Here - electronic signature

Date

You Must Check this Box to Confirm Signature

Confirm Signature

Success! This form has been submitted.