Religious Retreat Excursion Authorization
Participant Name:
Date of Retreat:
Location of Retreat:
Organizing Institution/Community:
Emergency Contact Name:
Emergency Contact Phone:
Medical Concerns/Allergies:
Authorization Statement:
I authorize participation in the above religious retreat excursion. I understand and accept all guidelines and responsibilities associated with this activity. In case of emergency, I permit the organizers to seek necessary medical attention.
Parent/Guardian Name:
Signature:
Date: