After School Program - Catoosa First

Phone number *

Grade *

Birthdate *

Gender

Consent Form Agreement

By signing my name below, being the parent or legal guardian of the student named above, I do hereby consent to the participation of my youth in all the scheduled youth activities of Catoosa First Church, and any other supervised activities customarily associated with its youth group, including youth rallies and overnight or weekend youth trips. Further, I certify that my youth is physically fit and adequately prepared to participate in all recreational and sporting events. If I wish to revoke this consent for any reason, I will promptly notify the youth leader in writing.

Parent/Guardian Name *

Date *