Youth Event: Rita’s Run

Join us for some good ole Italian ice from Rita’s.  We’ll meet at our regularly scheduled time of 5:30pm in the youth room.  Make sure to bring some cash and a permission slip with you so that you are able to participate with us.  The permission slip can be found below and can be filled and signed digitally.

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Youth Transportation Permission Form

This form is to be completely filled out and signed by parent or legal guardian before any child or youth under the age of 18 may be transported by church staff or volunteers for any church event. Permission will remain active until revoked by parent or legal guardian. If a child is dropped off for an event requiring transportation, that is considered permission for that particular event.

Parent/Guardians Name(Required)
Address

This form is to be completely filled out and signed by parent or legal guardian before any child or youth under the age of 18 may be transported by church staff or volunteers for any church event. Permission will remain active until revoked by parent or legal guardian. If a child is dropped off for an event requiring transportation, that is considered permission for that particular event.
Child's Name(Required)
MM slash DD slash YYYY
Child's Name
MM slash DD slash YYYY
Child's Name
MM slash DD slash YYYY
Child's Name
MM slash DD slash YYYY

I hereby give my permission for all the children listed above to ride the van or other vehicles used for church functions. I understand that my children will be under adult supervision. I further understand that in signing this form, I release and hold harmless Slate Belt Church and all other church-related functions. By signing this form, I release and hold harmless its trustees, officers, employees, interns, and any volunteers from any liability, past or future, fully and completely. I authorize the staff or designated medical professionals and/or volunteers to administer emergency medical assistance if I cannot be reached.

Additional Permissions
Consent(Required)
Signature(Required)
Typing your name here acts as your signature.
This field is for validation purposes and should be left unchanged.

Date

Jun 12 2022
Expired!

Time

5:30 pm - 7:00 pm

Location

Rita's Italian Ice & Frozen Custard
501 E Moorestown Rd #9, Wind Gap, PA 18091
Category

Organizer

Adam Livingston
Phone
918-277-6259
Email
adam.livingston89@gmail.com

SERVICE TIMES

Sunday School - 9:15 am
Morning Worship - 10:30 am

LOCATION

1620 Church Road
Pen Argyl, PA 18072

PHONE

610-863-9274