Young Christians Weekend '23
Please fill out this form and click submit.
Cost: $120
Dates: March 31st-April 2nd
We will leave after school Friday and return Sunday evening.
Location: Silver Dollar City Branson, MO
Student Name
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Parent Name
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Parent Phone
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Parent Email
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This address will receive a confirmation email
Student Phone
Student Birthday
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Emergency Contact Information
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Insurance Information
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Medications, frequency
*
I have been informed and understand that East Cross United Methodist Church will be taking photographs of children attending sponsored activities, including this trip, and that these pictures may be viewed inside the church building, on the East Cross website or other outside publications.
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Please select all that apply.
I give consent for my child(ren)'s picture to be used.
I do NOT give consent for my child(ren)'s picture to be used.
I give permission for my child to be added to the East Cross Church Life 360 group for this trip, and will be deactivated once the group gets home.
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Please select all that apply.
Yes
No
My child doesn't have a phone.
I give my permission for my child to receive pain reliever (such as Tylenol, Advil, etc.), antacids, and Benadryl from the supervising adults at this church function.
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Please select all that apply.
Yes
No
I understand that in the event medical intervention is needed, every attempt will be made to contact immediately the persons listed on this form. In the event I cannot be reached in an emergency during the activity dates shown on this form, I hereby give my permission to the physician or dentist selected by the activity director to hospitalize, to secure medical treatment and/ or an injection, anesthesia, or surgery for my child as deemed necessary.
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Please select one option.
Understood
I understand that all youth and church events are drug free (including vaping) alcohol free and weapon free. If my child is caught with any illegal substances at church or on a trip, I will work with them to make amends. This can include coming to retrieve my child in the event they are sent home.
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Please select one option.
Understood
Electronic Parent Signiture
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Todays Date
*
Submit
Description
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