Sweet Apple Park Night – World Harvest Church

Child's Name *

First

Last

Parent Cell

I certify that my child is physically well. I certify that no health-related reasons or problems preclude my child's participation in the activity mentioned above. *

If your child has any health concerns or things we should know, please list below:

In the rare case of emergency I understand that I will be notified of the situation as soon as practicable. I agree to pay any necessary expenses incurred in my child's medical treatment, including, but not limited to, all transportation costs to and from a medical facility and, if necessary, transportation to my home or medical facility of choice. *

Parent Signature *

I give my child permission to ride the World Harveest Church shuttle Sunday, December 3rd and pass out flyers at various shopping complexes in Roswell, Georgia between 1:30-3:45pm.