Escolar Documentos
Profissional Documentos
Cultura Documentos
Address ____________________________________________________________________________
Address ____________________________________________________________________________
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Name and dosage of any medications that child must take: __________________________________
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List any allergies that child has, including allergies to medications: ____________________________
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Date _______________________________________________________________________________
TRANSPORTATION RELEASE:
I give my permission to the bearer of this letter to transport my child to the program events sponsored
by Ketron Memorial United Methodist Church of Kingsport TN, for all programs that take place within
Kingsport TN and immediate surrounding areas. My child is allowed to travel out of Kingsport with the
WOW Kid’s Club when I have been informed of the specific destination, duration of the trip, and
intended event ahead of time.
Children will not be allowed to travel with anyone that has not been authorized in writing by the
parent/guardian. In the event that I cannot transport my child to and from the church for meetings or
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special activities, I give permission to allow the following persons to transport my child for me.
Appropriate identification may be asked for if adult leaders do not recognize a person bringing or
picking up a youth at the church.
My child has permission to arrive or depart from the WOW Kid’s Club meetings or special activities
by walking or bike riding to and from the church. I also give my permission for my child to leave the
WOW Kid’s Club meetings and special activities before the end of the event. Additionally, I understand
that by leaving, I release Ketron Memorial United Methodist Church, and the leaders of the event from
liability for any accident that may occur while not present at the WOW Kid’s Club meetings or special
activities.
Date _______________________________________________________________________________
PUBLICITY AUTHORIZATION:
I give permission for photographs taken of my child or me to be used for Ketron Memorial United
Methodist Church’s WOW Kid’s Club ministries’ publicity, printed or electronic.
Date _______________________________________________________________________________