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    NEMBY Jr. Bowling Form

    Uploaded by

    Mark Durksen
    This permission form provides the details of a bowling event for NEMBY Jr. on February 27th from 6:30-8:30 PM at Ina Grafton Gage Village. It collects student and emergency contact information, outlines behavioral expectations, and requires signatures for student agreement to the guidelines and parental permission for the student to participate in the supervised activity.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    NEMBY Jr. Bowling Form

    Uploaded by

    Mark Durksen
    38 views1 page
    This permission form provides the details of a bowling event for NEMBY Jr. on February 27th from 6:30-8:30 PM at Ina Grafton Gage Village. It collects student and emergency contact information, outlines behavioral expectations, and requires signatures for student agreement to the guidelines and parental permission for the student to participate in the supervised activity.

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    Permission form for NEMBY Jr. Bowling.

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    This permission form provides the details of a bowling event for NEMBY Jr. on February 27th from 6:30-8:30 PM at Ina Grafton Gage Village. It collects student and emergency contact information, outlines behavioral expectations, and requires signatures for student agreement to the guidelines and parental permission for the student to participate in the supervised activity.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    38 views1 page

    NEMBY Jr. Bowling Form

    Uploaded by

    Mark Durksen
    This permission form provides the details of a bowling event for NEMBY Jr. on February 27th from 6:30-8:30 PM at Ina Grafton Gage Village. It collects student and emergency contact information, outlines behavioral expectations, and requires signatures for student agreement to the guidelines and parental permission for the student to participate in the supervised activity.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    NEMBY Jr.

    Bowling Permission Form


    DATE: ! Thursday, February 27th LOCATION:! Ina Grafton Gage Village ! ! 413 Linwell Rd., St. Catharines TIME:!! 6:30 PM to 8:30 PM COST: ! $5.00 CONTACT: ! Mark Durksen if you have any questions: ! ! 905-937-6900 or [email protected]

    Name: _____________________________________________________ Phone #: _________________________________ Address: ___________________________________________ City: _________________________ Postal Code: ________ OHIP #: ____________________________________ Allergies: _________________________________________________ Medications being taken: ________________________________________________________________________________ Emergency Contact Person: _________________________________________ Phone #: ____________________________

    Student Co-operation Agreement Were glad that youre coming bowling with us and we hope that youll have a great time. To keep things enjoyable for everyone, there are a few simple guidelines to remember and live by: - Be respectful to the facility and staff and follow all facility rules and guidelines. - Respect the adult leaders and youth you are with. If an adult leader tells you to do something, obey them. - Ina Grafton Gage Village is a home for many people. Do not be disruptive to them. I have read the above Co-operation Agreement and, by signing below, agree to abide by it. Student Signature: _________________________________ Date Signed: ___________________________

    Parental Permission I give my permission for the above named student to go bowling with NEMBY at Ina Grafton Gage Village. I understand that all reasonable safety precautions will be taken at all times by NEMBY youth leaders during the event described above. I understand the possibility of unforeseen hazards and know the possibilities of risk. I agree not to hold Scott St. MB Church, Fairview MB Church or Grantham MB Church or their employees or volunteers liable for damages, losses or emergency. I hereby authorize an adult leader as agent for me, to consent to any X-ray examination, medical, dental or surgical diagnosis, treatment, and hospital care advised and supervised by a physician, surgeon or dentist (as appropriate) licensed to practice under the law of Ontario where the services are rendered, either at a doctors office or in a hospital. I expect to be contacted as soon as possible in this event. Signature of Parent/Guardian: ___________________________ Date signed: __________________

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