Professional Documents
Culture Documents
Registration and Medical Authorization Form Service Plunge 2015
Registration and Medical Authorization Form Service Plunge 2015
Registration and Medical Authorization Form Service Plunge 2015
MEDIA RELEASE
By submitting this form I allow the release of my childs name and image for congregational use (newsletters,
websites, bulletin boards, etc.), and that photos/videos produced during the 2015 Middle School Service
Plunge Day Camp events become the property of the congregations and can be used for congregation-related
purposes and publicity.
Parent/Guardian Name (please print) ____________________________________________________________
Parent/Guardian Signature __________________________________________________ Date _____________
T-SHIRTS
Participants will each receive a t-shirt. Please indicate the size preferred. (All t-shirts are adult sizes)
XS
XL
2XL