Youth Group Good Friday Lock-Out

Field Trip Details Location TBD

Winchendon/Gardner, MA 7:00 8:00 PM @ UPC 8:30 PM @ UPC 8:00 AM @ Residence 978-618-0909

What To Bring

Date Apr 6th 2012 Good Friday Service Departure Time Pick-Up Time Jerrys Cell #

Sleeping Bag & Pillow Footie Pajamas (if you have them) Hygiene Products $20 for Late-Night Dennys Field Trip

Cut off bottom portion of permission slip return to the Youth Group by Apr 6th 2012. Emergency Information In case of emergency, please contact: ___________________________________________________________ __________________________
Name/Relationship Phone

Special Instructions:

I give permission for my child,________________________________to attend the United Parish Church Youth Group Lock-Out on April 6th 2012. In the event of an emergency, I hereby give permission to the representatives of United Parish Church to act in my stead, giving consent to any hospitalization and/or medical treatment by a licensed physician or emergency team. I agree to be liable for any and all costs involved in such emergency medical treatment. I release and discharge the representatives of United Parish Church from any liability whatsoever in exercising permission for this activity.

X_________________________________________________________ __________________________ Parent or guardian signature Date