Everyone....a permission slip is attached. Please bring it with you the night night of the lock in and also post if you are attending and what you will bring. (food - Mexican Movies - Superheros) Also I will have them at mass and at the church. See you Saturday. Mr Gumbo 457-0633 Mr Matt 781-1856. Please note permission to watch the Passion; parents please initial if your child can watch.
CYO Permission Form
Event: _______________________________________________
Lock-In Movie Permission: Passion Of the Christ ____Yes ____No (Please initial)
Child’s Name:________________________________ Age: ____________
Parent(s): ___________________________________ Phone#: ______________
Address: __________________________________
__________________________________
Primary Care Facility: _____________________________________
Allergies / Special Needs:
________________________________________________________________
________________________________________________________________
2nd Child
Child’s Name:________________________________ Age: ____________
Allergies / Special Needs:
_________________________________________________________________
_________________________________________________________________
Remarks/Comments:
_________________________________________________________________
_________________________________________________________________
Consent to this event allows the CYO staff to act as temporary guardian in the interest of the child in case of emergency or incident. Parents or caregiver will be contacted immediately.
Neither the Hickam Chapel staff nor Parrish staff will be held responsible for incidents resulting from your child’s or the other children’s actions while attending the event.
Parent or Guardian Signature: _________________________________________________