Murdale Baptist - Parental Permission Form

Parental Permission Form for Children's Event

Please complete the following for the parent giving permission for their child(ren) to participate in the event sponsored by Murdale Baptist Church.

Parent's First Name

Parent's Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number (where you can be reached during the event.)

Email

Please complete for the child that will be participating in the event at MBC.

Participant's First Name

Participant's Last Name

Grade

Please list any Allergies or Special Needs of this child:

By signing below, I give permission for my child(ren) to attend this MBC children's event. In the event of injury, I release Murdale Baptist Church from any claim. I give permission for my child(ren) to ride in any vehicle designated by the adult in charge. I give permission for the person in charge to seek medical services if needed. I give permission for my child's image to be used by MBC in print or electronically for the purpose of publicity of this event.

Signature

Today's Date: