PERMISSION SLIP

Event -

Date -

Time -

Location -

Cost $$ -

Other Information -

__________________________________________________________

PERMISSION SLIP (18 YRS. & UNDER)

I give permission for (Name)___________________________________________
(Address) _________________________________________________________
to attend this event.  I understand that Lighthouse Tabernacle can not accept any
responsibility for accident or injury.

__________________________                        _____________
(Parent or Guardian)                                                     Date

Phone in Case of Emergency _________________________________