Church Transportation Permission Slip

This form is to be completely filled out and signed by the parent or legal guardian before a child may ride in the church van. Permission will remain active until revoked by the parent or legal guardian.

Parent/Guardian Name

Address

This address will receive a confirmation email

Cell Phone

Do you give permission for us to call and text your teen for pick-up and drop-off information? If yes, please provide their phone number:

Please list all children in your household who have your permission to be transported by church staff and volunteers for church events. All drivers have undergone a criminal background check.

**Children under 5 are required to ride with a parent.

Name of Child #1

Name of Child #2

Name of Child #3

Name of Child #4

Emergency Contact Name

Emergency Contact Phone

Release of Liability

I hereby give my permission for all the children listed above to ride the van or other vehicles used for church functions. I understand that my children will be under adult supervision. I authorize the staff or designated medical professionals and/or volunteers to administer emergency medical assistance if I cannot be reached.

Parent/Guardian Signature

Date

Description

Please fill out this form and click submit.

Church Transportation Permission Slip

Description

Please Fix the Following