Kids/Teens Release Form2025 Participant Name * First Name Last Name Grade * 4 5 6 7 8 9 10 11 12 Birth Date * MM DD YYYY Parent/ Guardian Name * First Name Last Name Parent/ Guardian Email * Parent/ Guardian Phone * (###) ### #### Trip * SuperStart MIX MOVE T-Shirt Size S M L XL 2XL Allergies Health Insurance Company * Group Number * Policy Number Medical Release * Medical Release: I do hereby attest that I am the parent or legal guardians of the Participant above. He/She has my permission to travel with Thrive Christian Church. I authorize the representitive of TCC to consent to any necessary medical examination, diagnosis or treatment in the event that I am unavailable at the phone number listed above. I promise to pay for any and all medical attention received by the above mentioned child. I Agree Thank you!
