PERMISSION FORM

Parkway Baptist Church - 12465 Olive Blvd. - St. Louis, MO 63141 - 314-434-2310

I give permission for my son/daughter, ____________________________________________,

to participate in ________________________________________, on __________   ____, 2010.

I will hold harmless any of the drivers associated with this outing.

Parent's Name (please print)

Parent's Signature

Phone Number

Address

Student's Date of Birth

Print in Landscape Mode