Encounter Student Travel Waiver

*This form gives us (FBC SNYDER) the right to transport your child via bus, to and from any event. By signing this form, in the event of an emergency you release FBC SNYDER of any and all damages. You also give FBC SNYDER the right to pursue medical assistance if necessary for the wellbeing of your child. The attached form must be completed before student will be permitted to participate in any trip. If you have any questions contact Student Pastor Josh Lewis - 501-941-9983.

VERBAL APPROVAL WILL NOT BE ACCEPTED

Parent Guardian First Name

Last Name

Email

Student First Name

Last Name

Message

Additional Student First Name

Last Name

Additional Student First Name

Last Name

Does the student have any special health problems or handicapping conditions which will require special attention or supervision on this field trip?
Yes
No

If yes, what is the problem and what special considerations should be made?

BY CHECKING THIS FORM YOU AGREE TO ALLOW FBC SNYDER TO TRANSPORT YOU CHILD & RELEASE THEM FROM ANY AND ALL LIABILITY
Yes
No

BY INITIALING THIS FORM YOU AGREE TO ALLOW FBC SNYDER TO TRANSPORT YOU CHILD & RELEASE THEM FROM ANY AND ALL LIABILITY

Submit

Encounter Student Travel Waiver

VERBAL APPROVAL WILL NOT BE ACCEPTED

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