Tween / Youth Ministry Permission Form                                                       1st United Methodist Church LaPorte

Participant Information:

Parent / Guardian Information:

Emergency Contact Information:

Medical Information:

I give permission to give non-prescription (i.e. Tylenol, Benadryl, throat lozenges) medication (circle one)  Yes / No

Insurance Information

Photo Waiver:

I give First United Methodist Church permission to use photos of my child for bulletin boards, newsletters, Facebook, or scrapbooks.