First Baptist Church – Louisville, GA

Children’s Choir Permission Form (2023-2024 School Year)

This form is to be completely filled out and signed by a parent or legal guardian before a child may ride the bus.

Name of Child #1 *
First
Last
If more than 1 child please list them in the boxes below.
Parent's Email Address *
Relationship to you
Grade
Child's Birthday
Name of Child # 2
First
Last
Relationship to you
Grade
Child's Birthday
Name of Child # 3
First
Last
Relationship to you
Grade
Child's Birthday
Parent or Legal Guardian (First & Last Name)
Address
Address Line 1
Address Line 2
City
State
Zip Code
Home Phone
Cell Phone
Do you attend church
Yes
No
If so, where?
Emergency Contact Name
Emergency Contact Phone Number
Please list any allergies (food, medication, etc.)
I give First Baptist Church of Louisville, GA permission to photograph my child/children and use his or her picture solely for the church’s website or Facebook page. We will never publish a child’s name with any of its publications.
Yes
No
I, hereby give my permission for all children listed above to ride the bus, and to participate in the After School Children’s Choir Program at First Baptist Church of Louisville, GA. I understand that my children will be under adult supervision at all times. I further understand that in signing this permission slip, I release First Baptist Church of Louisville, GA, its employees, its membership, and any volunteers from any liability, past or future, fully and completely. I authorize designated medical professionals to administer emergency medical assistance if I cannot be reached.
Signature of Parent or Legal Guardian (type your name in the above box)
Date