Student Ministry Permission Form

  • I give permission for my child to take part in this activity
  • I hereby grant/do not grant permission for my child's/children's) image to be included in pictures, videos, promotional materials, and publications connected with South River Baptist Church.
  • Sponsored by South River Baptist Church on this date.
  • MM slash DD slash YYYY
  • I am fully aware that there will be ample supervision for this event. I have completed and witnessed the notorization of a Medical/Liability Release Form for my child. By signing (typing in your name) this permission slip, I am confirming that the information on his/her Medical/Liability Release Form is current and up to date. I understand in the unlikely event of an accident or emergency that my child will receive adequate care based upon the information given.
  • MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.



2659 S. Chipley Ford Rd.

Statesville, NC 28625