Student Ministry Liability Form
This is a Mission Point Church / Oneighty Student Ministry Sponsored Event. I hereby give my child permission to participate in the following event.
Name of Student: *
Your answer
Event and date: *
Your answer
Name of parent(s)/guardian(s): *
Your answer
Address: *
Your answer
Cell phone number: *
Your answer
Home phone number:
Your answer
Work phone number:
Your answer
Name of Emergency contact: *
Your answer
Cell phone number of Emergency Contact: *
Your answer
Home phone number of Emergency Contact:
Your answer
List allergies or medical conditions: *
Your answer
Is sponsor authorized to approve medical treatment? *
Is participant covered by personal/family medical insurance? *
If yes, name of insurer and policy or group number.
Your answer
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