FC Kids Medical Release Form

Parent/Guardian *
Parent/Guardian
Phone *
Phone
Date *
Date
I give my child permission to participate with Foundations Church events in 2018. *
Participant Name *
Participant Name
Birthday *
Birthday
Ex. 123456789
Address *
Address
Effective date *
Effective date
Physician Name *
Physician Name
Physician Number
Physician Number
1st Emergency Contact *
1st Emergency Contact
Best Phone Number *
Best Phone Number
2nd Emergency Contact *
2nd Emergency Contact
Best Phone Number *
Best Phone Number
Medical Release *