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Parent Permission Form
This form covers all Pleasant Hill Baptist Church student activities for one calendar year.
Your name
*
Last name
Email address
*
Address
*
Home
Work
Other
Country
Country
Street address
Apt/unit/box (optional)
City
State
Postal code
Phone Number
*
Phone type
Mobile
Home
Work
Other
Student's Name
*
Birthday
*
Date
Grade
*
Select…
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Parental Consent
This section requires your parental consent for your child to participate in student events conducted by Pleasant Hill Baptist Church.
Parental Consent: I or We, the undersigned, parent(s) of a minor, do hereby consent to said minor participating in student events conducted by Pleasant Hill Baptist Church in Somerset, KY.
*
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