United Congregational Church
of Tolland

United Church of Christ
45 Tolland Green, Tolland, Connecticut 06084
Phone:  860 875-4160   Fax:  860 871-0129


Youth Fellowship Trips

Parental Permission and Medical Authorization

 

I, *grant permission for * my son/ daughter, a minor, age , born ,19, who participates in the United Congregational Church Youth Group Program to participate in local day trips with the Youth groups.  Trips may involve traveling with the group to locations up to 50 miles in radius from the church during the program year of September 2010 through June 2011.

I understand that the adult(s) in charge are the Directors of Youth Fellowship, Gary Lotreck and John Frassinelli and/or in their absence, the acting Adult Youth Advisor(s).

In the event of a medical emergency, and that I/we can not be contacted at the phone numbers listed below, I authorize medical personnel to provide the necessary care and treatment deemed appropriate.

*Email:  

*Phone/Cell:

Special Instructions (medications, allergies, etc.)

I give my permission.  Yes   No

We do take a lot of pictures at PF and the church’s web committee is interested in using them on the youth page.  We need your permission for pictures of your child/children to be posted on the church website.   Please indicate below if you give permission.  

I give my permission.  Yes   No

 

 

Updated October 20, 2011
Webmaster RBittner@charter.net

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