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Please list any allergies, medical conditions, and/or physical limitations.

I, the parent or legal guardian, of the child listed above, give permission for my child to be transported by an approved representative of Trinity Evangelical UMC in a church or private vehicle, in according with the church policy, for Wednesday evening activities at the church. I release Trinity Evangelical UMC, together with all representatives, from any and all claims resulting from injury and/or damage that may be sustained by my child.

I understand that if my child no longer has permission to ride in the vehicle, it is my responsibility to contact Trinity Evangelical UMC and informthem so my child may be remove from the transportation service.

Parent/Guardian if you acknowledge and agree that all the information is correct and you have given Trinity Evangelical UMC permission to transport your child please type your name below. The typed named below will be a symbol of your signature for this transportation release.