2017 Baja Winter Mission Parent/Guardian Questionnaire
Child's Name *
Child's Age *
Parent/Guardian Name *
Current Grade Level *
Parent/Guardian Phone Number *
Email Address *
Home Address (Street, City, State, Zip Code) *
Are you supportive of your child attending this mission trip? Why or why not? *
What medications/medical or health requirements does your child have (if any)? *
Does your child have any other requirements and/or limitations that must be taken into consideration to allow for his/her participation (e.g., court requirements, legal, medical, etc.)? *
Please include any other information/thoughts you would like to share to help us make the decision on including your child. *
Should my child require any medical treatment (emergent or not) for any reason, I allow the medical staff on board to assist my child with his/her medical needs.
I allow my child to participate in any activities set forth by the Baja Mexico Mission Trip. I understand the terms and conditions of this application and my child's participation in the trip. I understand the possible risks involved. In consideration of my child's participation, I agree to release Baja Mission Leadership and staff involved from any and all liability, loss, and/or injury to person or property suffered by any person in connection with this trip.
By participating in this mission trip, I acknowledge that any photos/videos may be used for publicity purposes. *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy