Bridge Youth Permission Form 2024-2025

Please fill out ONE form for each child and click submit.

Your name *

Email address *

Parent/Guardian Name, first and last: *

Phone number *

Secondary phone number *

Address *

I/we are the Parent/Legal Guardian(s) of: (place CHILD'S FIRST & LAST NAME below) *

Do you consent to his/her involvement in events sponsored by The Bridge Youth Ministry located in Chino, CA 91708? *

Yes

Do you give permission for the leadership of the Bridge Youth program to admit your child to medical care facilities and give authorization for your child to be treated immediately if an injury or illness should occur while participating in our event? *

Yes

I do not hold The Bridge Church (Chino, CA), its Youth Program or any of its leadership responsible in any way for any incident or accident that may occur while participating in our event. Having read the above statement, indicate your agreement. *

Yes, I agree with the above statement

Have you read and fully understood the permission slip above and do you desire your child to participate in Bridge Youth activities? *

Yes

Child's information

Gender: *

Female

Male

Date of Birth: *

Grade *

Allergies/medications/health concerns: *

Health Insurance name and policy number: *

Additional information:

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