(by Debbie Myers, Idaho)
Had to make these permission slips when the
bishop's office was out. These are verbatim from the one slip that I had.
The Church of
of Latter-Day Saints
PARENTAL or GUARDIAN Permission and Medical Release
ACTIVITY: "HORSES, HORSES, HORSES" - Cultural Primary Activity Day
(INVOLVES RIDING around town in PERSONAL VEHICLES)
DATE: Saturday, 11/03/01 - 9:45 am to 12:00 pm WARD: Ocala 2nd STAKE: Gainesville, FL
PARTICIPANT: ___________________________ DOB: __ / __ / __ PH: _____ - ________
PARENT/GUARDIAN: _____________________________ WORK PH: _____ - _________
Does the participant have any of the following?
( ) Special diet ( ) Allergies ( ) Medication ( ) Chronic illness ( ) Limiting physical condition
( ) Surgery or serious illness in the past year (If yes, please explain on the back of this form.)
I give permission for my child/youth to participate in the activity listed above and authorize the adult leaders supervising this activity to administer emergency treatment to the above-named participant for any accident or illness and to act in my stead in approving necessary medical care. This authorization shall cover this activity and travel to and from this activity.
Parent or guardian's signature: Date: