Wednesday Youth Loft Permission Form
The Youth Loft will be open on Wednesdays from 3:30 p.m. to 5 p.m. Snacks will be provided. Please complete the permission form below.
I give permission for my child:
Name: *
Your answer
Age: *
Your answer
....to participate in the following (select all that apply): *
In case of an emergency, I give permission for my child to receive medical treatment. In case of such an emergency, please contact:
Name: *
Your answer
Phone: *
Your answer
Parent/Guardian Electronic Signature: *
Your answer
Date: *
MM
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DD
/
YYYY
Submit
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