Children & Youth Ministry Permission/ Medical Release Registration Form

This is a legal and binding document. Read it carefully before signing. This permission and medical form gives the students named below permission to participate in Children & Youth Ministry events from September 1, 2016 through August 31, 2017, as well as permission for Caledonia CRC & its leaders to seek medical treatment for that student in case of an emergency.

This form is not available.

Payment

Payment Summary

Based on your selections, there is no payment due at this time.

Please click the 'Process' button to complete your submission.


Total:

This form allows partial payment with a minimum of .

Amount to pay: $
Remaining Balance:

Credit Card/Name - Payment Method

* Indicates a required field

Your transaction was successful
Submission ID: JIM
Confirmation code: JIM
Select family members to auto add to form:
Jim Smith
Jim Smith