Community Presbyterian Church
Summer Journey 2018
(June 18– August 3, 2018)
511 Celebration Avenue
Celebration, Florida 34747
407-566-1633

“Train up a child in the way he should go, and when he is
old he will not depart from it.” Proverbs 22:6

REGISTRATION AND EMERGENCY CONSENT FORM

PICK UP IMFORMATION: THE FOLLOWING PEOPLE HAVE PERMISSION TO PICK UP MY CHILD:

IN CASE OF EMERGENCY AND PARENTS CANNOT BE REACHED, THE FOLLOWING PERSON(S) SHOULD BE CONTACTED:

As Parent and/or guardian, I do herewith authorize treatment by a qualified and licensed medical physician in case of a medical emergency. This authority is granted only after reasonable effort has been made to reach me.

PHOTOGRAPHY /VIDEO PERMISSION:

As the parent/guardian, I give permission for any video images or photographs that may be taken of the subject of this release during Summer Journey events to be used, distributed, or shown as Community Presbyterian Church sees fit.

ROSTER PERMISSION:

As the parent/guardian, I give permission for my e-mail address to be used to send out parent e-mails regarding upcoming events at Summer Journey and/or Community Presbyterian Church.