Parent or Guardian Name *

This serves as an electronic signature.

First Name

Last Name

Parent or Guardian Cell Phone *

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By Checking this box I am giving consent for my child or children to be transported by Radiant Church staff to the church or youth functions and outings (In church vehicle or personal). *

I consent!

I understand that my child will be transported by a background checked staff member of Radiant Church. *

I consent that Radiant Church or staff members are not liable in case an accident may occur. *

I understand that all precautions with be taken in order to ensure safe transportation for my child, and if my child does not follow guidelines and instructions they may no longer be able to ride *

In any event that I cannot be reached to make arrangements for emergency medical care in the event of an accident, I hereby authorize Radiant Church to take my child to the nearest hospital for emergency care. *