Youth Permission Form - Celebration Church

CELEBRATION YOUTH PERMISSION FORM

Participant's Name(Required)

First Last

Birthdate(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Emergency Contact Person

First Last

Emergency Contact Phone

Allergies or Special Instructions

Photo Release

As a parent or guardian of this child, I hereby consent to the use of photographs/video taken during the course of church events for publicity, promotional and/or fundraising purposes. I do this with full knowledge and consent and waive all claims for compensation for use, or for damages.

Signature

Date

Sundays at 9:00am and 11:00am | 745 April St, Waterloo, IA

CELEBRATION YOUTH PERMISSION FORM

Photo Release

745 APRIL STREET, WATERLOO, IA 50701

Join Us Sunday Mornings at 9am and 11am

*You can watch our first services on our YouTube or Facebook