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CHILD CONSENT FORM
Children Ministries Consent Form
Consent Form
Consent Form for WSUMC
Child
*
Date
*
MM slash DD slash YYYY
Parent's
*
Phone
*
City
*
State
*
Zip Code
*
School
*
Grade in or going into
*
Pre-K
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2nd
3rd
4th
5th
6th
7th
8th
9th
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*
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*
Allergies
*
Medications
*
May we administer Tylenol if needed?
*
Yes
No
Parental Consent
Consent
*
Wayne Street Church has my consent.
I (WE) are the parent or guardian and have given our consent for our child to participate in activities within the Wayne Street Church.
Parent/Guardian (print)
*
Parent/Guardian (Signature)
*
Parent/Guardian (print)
Parent/Guardian (Signature)
Date
*
MM slash DD slash YYYY
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