Overflow Youth Group 

1 Thessalonians 3:12 

May the Lord make your love increase and overflow for each other and for everyone else, just as ours does for you.

Permission Slip for Summer Events

Trip Details:
Destination:Ice Skating
Date: ____________________
Departure Time: ____________________
Return Time: ____________________
Transportation: ____________________
Cost (if any): ____________________
Supervising Adult(s): ____________________
Participant Information:
Minor's Full Name: ____________________
Age: ________
Parent/Guardian Name: ____________________
Phone Number: ____________________
Alternate Phone Number: ____________________
Parental Consent and Medical Authorization:
I give permission for my child named above to attend the Dairy Queen trip. I understand that reasonable supervision will be provided during the outing. In the event of an emergency, I authorize the supervising adult(s) to secure medical treatment for my child if I cannot be reached immediately.
Medical / Emergency Information:
Allergies or Medical Conditions: ____________________________________________
Medications: ____________________________________________
Emergency Contact Name: ____________________
Relationship to Minor: ____________________
Emergency Contact Phone: ____________________
Parent/Guardian Signature: ________________________________
Date: ____________________
Please return this signed form before the trip.