INCREASE Youth Ministry

For you

Parents

Review form

My Digital Consent

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Your submission is your consent. Thank you!

Youth Name

Youth Age

Birthday

Grade

School

Youth Address

Youth Phone

Youth Email

Parent Name

Parent Phone

Parent Email

Health Insurance

Policy Number

Emergency Contact

Emergency Phone

Emergency Contact

Emergency Phone

Approval and Review

I have read and reviewed and approve of the release form.

I hereby give my digital signature as legal consent.