Medical Release Authorization Form

Medical Release Authorization Form

http://bit.ly/MedRelForm

Everyone participating in youth events must fill out this form and turn it in.

It is good for one year following date of completion.  In the header you will see "Effective Dates:"  Fill in the beginning year to the ending year (i.e., 2011-2012).

In the consent you will see two blanks that allow for the same input:
"___________________________________has my permission to attend all youth activities sponsored by the Airline Drive Church of Christ from _________________ to ______________ ."
The first blank is for the student's name.  The second two are for the dates (i.e., 2011 to 2012).