Church Transportation Permission Slip

We offer rides to kids and adults of all ages on Sunday mornings. We also offer rides to kids and youth on Wednesday nights for our programs that begin at 6:30 PM.

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 the form and click Submit. After receiving your form, we will reach out to you to discuss details for pick up and drop off.

Church Transportation Permission Slip

Description

Please Fix the Following