Confirmands Trip

Online Permission Slip for Confirmation Trip & RSVP
Temple Israel (1140 Governor St, Springfield, IL 62704), on Feb. 21, 2019, 5:00 p.m. - 8 p.m.
Dinner is included.
Parents, you are encouraged to join us for the visit and dinner.

* Indicates required field

Guardian / Parent Name *

First

Last

Emergency Contact Phone Number *

Relationship to Minor *

Email *

Name of child/youth participating *

First

Last

I desire for my child/youth to participate in the following activity/trip associated with Westminster Presbyterian Church *

Son Daughter Minor under my supervision and control

Name of child/youth participating *

First

Last

I desire for my child/youth to participate in the following activity/trip associated with Westminster Presbyterian Church *

Daughter Son Minor under my supervision and control

Does your youth need a ride from Westminster? *

Yes, I will drop my youth at WPC by 5 p.m. No, I will bring my youth to Temple Israel by 5:30 p.m.

# of people attending (including youth) *

Digital signature of Legal Guardian (please print your name) *

Submit