5th and 6th Grade Release Statement

Please complete all fields on this form, including the signature box at the bottom.

*Child's First Name:
*Child's Last Name:
*Child's Grade:
Ministry Participation (please select all that apply):
*By typing my first and last name in this box, I am signifying that I am the parent or guardian for the child listed above and have given permission for them to be dismissed at the end of their class time, on their own, to meet me at a predetermined location at Grace Baptist Church.
*Date
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