Youth Permission Form

This form is required for all field trips outside of the church

Youth Permission Form
July 2025 - August 2026

Youth Permission Form

Please complete this form for your young person each school year and/or for special events

Name - Parent/Legal Guardian

Date required

Youth's First Name

Youth's Last Name

Youth's Phone (if applicable)

Youth's Pronouns

Allergies or other concerns

Emergency Contact First & Last Name

Emergency Contact Phone

Second Emergency Contact First & Last Name

Second Emergency Contact Phone

Anything else to pass on?

MEDIA RELEASE: MPLC may use images and video clips of students in communications such as emails, website content, postings to official social media platforms, and in print publications. Note: we do not name or tag minors or parents in social media posts. Is it okay to use any photos or videos of your youth/family?

Yes

By submitting this form with your name and email, you agree to the following statement: I authorize the youth event chaperone or other responsible adults to authorize any physicians or medical personnel at any medical facility or first aid station to provide medical care for my child as may be deemed necessary in the event of an emergency.

Thank you for submitting your youth's permission form for 2025-2026. If this information should change during the school year, please submit a new form to update our records, or speak to Pastor Nathan Pratt.

Youth Permission Form

Youth Permission Form July 2025 - August 2026

Youth Permission Form

Youth Permission Form
July 2025 - August 2026