Student Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone *

(###)

###

####

Parent/Guardian Name(s) *

First Name

Last Name

Cell Phone *

(###)

###

####

Parent/Legal Guardian Signature *

My child listed above has the permission of the name typed below to participate in the following described event: Six Flags Event on 6/5/2025 By typing my name, I understand that participation in the stated event includes transportation to and from the destination by an adult worker for the Quest Church Youth Ministry. I have also filled out the Quest Church Youth Ministry Medical Information and Release Form this year (2025).

First Name

Last Name

Parent/Legal Guardian Signature Date *

MM

DD

YYYY