Forms

UPCOMING
EVENTS

YOUTH TRIP PERMISSION & RELEASE FORM

Youth Trip Permission & Release
The undersigned parent/guardian of:
Hereby gives permission for the above named child to accompany the volunteer staff of Antioch Missionary Baptist Church to any and all functions of the church.

In consideration of the advantages of theses activities the undersigned agrees that the Antioch Missionary Baptist Church of Louisvville KY, it's agents and employees, and the driver and/or owner of the vehicles used for church related activities shall be exempt from liability of damages for bodily injury or property damage that might occur during said trips, except to the extent of insurance liability as provided by law.

Address
Address
Address 1
Address 2
City
State/Province
Zip/Postal

Health Information

Any known allergies?
Please note: Any prescribed medications (i.e. insulin) cannot be administered by members of Antioch Missionary Baptist Church without explicit written permission from the guardian
Do you give permission to contact medical personnel in the case of an emergency?

Emergency Contacts