My teen, ______________________ has permission to go to _______________________________ with the Liberty Baptist Church Youth Department on ____-____-2007.

- I understand every precaution will be taken for the care and safety of my child and all those attending this activity. Nevertheless, I do hereby agree not to hold Liberty Baptist Church or any personnel liable for any mishap which might occur while traveling to and from or during the above mentioned activity.

_____ I have already completed and submitted an Emergency Medical Authorization form, and all the information is current.

_____ I will complete and submit an Emergency Medical Authorization form and return it to Liberty Baptist Church.