Faithwalkers East

Faithwalkers East Consent Forms

Ridgecrest Conference Center, Asheville, North Carolina

  Instruction Sheet

Chaperone Form and Medical Release

This form should be filled out by a parent/legal guardian who is sending his/her child(ren), under 18 years of age, to the conference with a chaperone.

  Chaperone Form and Medical Release

Pages 1-2: Chaperone Form

  • Signatures required from both the chaperone (page 2) and the parent/legal guardian (page 2.)
  • Must be mailed to GCC office (621 W. Broad Street, Suite 2-F, Pataskala, Ohio  43062.)
  • Form must be received by: December 10, 2010.

Pages 3: Medical Release

  • Signed by parent/legal guardian
  • This form must be given to the chaperone-do not mail to GCC office.

Family Responsibility Acknowledgment

This form should be filled out by a parent/legal guardian attending the conference with his/her child(ren) who are under18 years of age.

  Family Responsibility Acknowledgement

  • Filled out and signed by parent or guardian
  • Must be mailed to office (621 W. Broad Street, Suite 2F, Pataskala, Ohio 43062) Form must be received by:Monday, December 10

If you have any questions contact the GCC office.