Service Journey Kenya - Permission for Minor

Service Journey

Permission for Minor

I give my permission for my child, _____________________, age __________ to participate in

the _____________________________activity of Expanding Opportunities

from __________________ to _______________.

I give my permission for Expanding Opportunities and its staff to provide medical assistance as necessary.

I give my permission for the treatment of my child by any medical personal necessary.

I give my permission for the transport of my child to and from such treatment by the most expedient means.

I have signed the liability waiver and hold Expanding Opportunities harmless.

___________________
Date

_______________________________________
Signature of parent or guardian

_______________________________________
Print Name

Service Journey Home Page	Service Opportunities: Kenya	Experience Education in Kenya	Service Opportunities: Peru
Printable Application form	Schedule: Kenya	Experience Art in Kenya	Schedule: Peru
Liability Waiver	Program Fee: Kenya		Program Fee: Peru
Permission for Minor	General Information for Kenya

For more Information:
Write: Expanding Opportunities, 84 Payson Road, Brooks, ME 04921
Call 1-888-760-7943; 1-207-722-3708