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Magic Mountain Trip!!!

Magic Mountain Trip!!!

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Published by Phil de Martimprey

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Published by: Phil de Martimprey on Aug 29, 2012
Copyright:Attribution Non-commercial

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08/29/2012

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The Details…
-
TO SIGN UP YOU HAVE TO TURN IN THE ATTATCHEDPERMISISON SLIP & PAYMENT BY
Sunday SEPTEMBER 9
TH
!!
-
Cost is $65 for two days at the park. This includes tickets, transportation andlodging.
-
Meet at Grace Community Church at 2:30pm on Friday.
o
We are Planning on being back around 8pm on Saturday. We will haveyour student contact you with precise time on our return.-To bring:
o
Toiletries
o
Sleeping bag/pillow
o
Change of clothes
o
Money for four meals on the trip
-
Do not Bring
o
Weapons of any sort, illegal substances.
 
Six Flags Trip
Day
:
Friday September 14
th
at 2:30pm to 15
th
at 8pm
Meet @ Grace Community Church, @ 2:30pmCost: $65 to cover tickets, lodging, transportation
Parental Consent, Medical Authorization & Release
I give my permission for my child to participate in “six flags trip” with
Grace, Mt View, First Congregational, Calvary Chapel, New Life Assembly Churches.September 14-15th, 2012.T
he undersigned hereby consents to & authorize minor child named below to participate in
SixFlags Trip
conducted by
the above churches
(“Church”). We further authorize minor child totravel with representatives of the Church in private or church vehicles. If a parent, family physician,or dentist cannot be contacted promptly, and a medical or dental emergency has been determinedto exist, the undersigned parent or guardian of the minor child named above hereby authorizes anyrepresentatives of the Church for and on behalf of the undersigned, to consent to any x-ray,anesthetic, medical, surgical or dental diagnosis of treatment and any hospital care deemedadvisable and rendered by any licensed physician, or surgeon, EMT, nurse, or dentist, whether inhis/her office or in any licensed hospital or health care facility. This authorization is given in advanceof any such required care for purposes of empowering any such representative or official of theChurch to give the above described consent for any such medical, or dental, as he/she may deemadvisable. We herby agree to pay any and all reasonable charges incurred as a result of any suchmedical or dental treatment and to hold the Church and it’s representatives and officials harmless. The undersigned hereby release the Church and its authorized representatives and officials of andfrom any and all liability to the undersigned, or tour minor child, arising out of or in connection withactivities related to the Church, or any travel connected therewith, except for such liability as mayarise from the gross negligence or willful misconduct on the part of the Church or its representativesor officials. To the extent that any applicable law prevents or prohibits the undersigners’ release of the Church from any liability to our minor child as set forth herein, we hereby agree to indemnifyand hold harmless the Church and its representatives and officials of and from any such liability asmay be imposed upon any of them.
Student’s name___________________________________________ (PLEASE PRINT)Parent’s name____________________________________________ (PLEASE PRINT)Parent or guardian’s signature _____________________________________________ Date_____________ 
 
Phone # parent can reached at
____________________________ __________________________ 
(home) (cell)
Insurance Company ______________________________________________Policy # ______________________________________________________

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