Parent/Guardian Information
Please be as thorough as possible so that we may be able to contact you and keep you updated with changes, or in the event of an emergency.
*Please provide a phone number where you can be reached during the event.
Emergency Contact Information (if parent/guardian is unable to be reached)
I give permission for my child(ren), listed above, to attend the CLIFF Movie Night Lock-In described above and participate in all of the activities associated with said event.
**By entering my name in the box below and pressing submit, I am electronically signing my name on this form.
If you would like to pay for this event via cash/check (made out to "MSBC Youth Ministry"), you may do so, but please select that "payment" option below.
If you would like to pay for this event via credit card, you may do so below, BUT there is a fee.