consent form

GALILEE B-P CHURCH
YOUTH FELLOWSHIP / TEENS FELLOWSHIP
HIKING AT BUKIT TIMAH HILL
12TH MARCH 2011
MEET IN CHURCH: 2PM

Consent Form


Name: _________________________________________ Age: ______________
Address: _______________________________________ Sex: M / F
_______________________________________________



Parent’s / Guardian’s Consent
I/We the undersigned do hereby give permission for the above-mentioned person to attend the above mentioned activity. I/We authorize Galilee B-P Church and/ or its representatives to obtain any medical treatment for the said person during the conduct of any program, ministry or activity in connection with the activity whenever necessary. I/We will also not hold Galilee B-P Church and its representatives liable in any way.
The hike will be at Bukit Timah Hill.
Any enquiries, please contact Dness Charissa Heng: 96820308
Shaun Teo: 97898442
Simon Magdalene: 85117641



_________________________________________________ ________________
(Name and signature of parent/ legal guardian) Date

The child above has a medical history of:
________________________________________________________________________
________________________________________________________________________


In the event of an Emergency, please contact:
Name: ___________________________________________
Address: _________________________________________
_________________________________________________
Tel: ___________ (H) ____________ (O) ___________ (Hp)
Relationship to child: ___________________________