MSM Return of the Roadtrip

6/30-7/2/21/2011| $65| Meet at 1BL at 6pm on 6/30/2011. Return at 9pm on 7/2/2011. NOTE: All events require payment for Sign Up to be complete.

Today's Date

Student Name *

(First & Last)

Grade *

Parent Name *

Parent Email *

Permission Slip *

All off-campus events require a permission slip which is available online.

I have one on file for this year

I will fill one out before the event & send it with my student

Parent Contact Phone *

# to call during event

I allow my student to attend this event with First Baptist Church of Lakewood. I understand that transportation will be by church bus and or leader/staff vehicles. In an emergency I authorize medical treatment for my student. I authorize use of photographs and video recording of my student at the churches discretion.

I accept

Notes

Student Email