Parental Permission Form

Event: Summer Impact Camping
Where: Paisley, Ontario
When: Wednesday 8:00pm – Friday (June 28th- 30th)
Cost: $65

I/we agree to allow __________________________ to go to the Summer Camp on June 28th- 30th with Riverside Baptist Church youth group. I/we agree to give permission to the leaders to make any necessary decisions regarding the health and welfare of my son or daughter while in their care. The leader will notify me at any time during the trip regarding any problem involving my son or daughter. I release the church, including leaders on the trip, from liability for any accident or other injury. I/We also understand that to run an effective camp we have to have Rules and will obey these simple rules: To have: Respect for God, Respect for leaders, Respect for Peers & Involvement These are critical rules for a fun weekend!


___________________________ ___________________________
Parent / Guardian Signature Print Name


___________________________ ___________________________
Student Signature Print Name


Health Card Number: _______________________________________________

Allergies:________________________________________________________

Home Phone Number:_____________________________________________________

Emergency Phone Number:_________________________________________________





Would you consider joining us in prayer for the youth going on this trip? We are praying for a safe, fun weekend that God will use for His glory. Pray that the teens will be challenged to walk closer in their relationship with Christ. Being a Christian is living day by day living and telling others the truth. Truth is worth seeking and telling!