IF YOU ARE UNDER AGE 18: ADDITIONAL SIGNATURES ARE NEEDED.

THIS PAGE IS TO BE FILLED OUT IF YOU ARE 15, 16, or 17 YEARS OLD.

 

MY FULL LEGAL NAME IS________________________________________

 

 

If you are 15, 16, or 17 years of age at the time of this trip….
  • You must come with a parent, guardian, or another responsible adult (does not have to be related) over the age of 25.

If you are 15, 16, or 17 years of age at the time of this trip, and are coming with a parent or guardian, you must have their signature…
  • Must have the signature of your accompanying parent or guardian below:

 

I will be on this trip and take full responsibility for my teen’s health, dress, conduct, safety, and well-being while on this mission trip. I have read and agree to enforce the Conduct and Dress Code.

 

X______________________________________________________

   signature of accompanying parent/guardian                              date 

 

If you are 15, 16, or 17 years old at the time of this trip and NOT coming with your parent or guardian, we must have these signatures…….

 

 

 

 

 

 

 

 

 

 

(NOTARY SEAL)

 

 

        

 
  • The signature of the adult (over the age of 25) who is taking responsibility for your health, dress, conduct, safety, and well-being while on this trip:

 

I will be on this trip and take full responsibility for this teen’s health, dress, conduct, safety, and well-being while on this mission trip. I have read and agree to enforce the Conduct and Dress Code.

 

X______________________________________________________

      signature of accompanying adult                                             date

 

AND
  • The NOTARIZED signature of your parent or guardian giving permission for you to go on this trip.

 

I give permission for my child,____________________________, to be on this mission trip under the full supervision of the adult, over age 25, listed above, with whom I am entrusting my child’s care in the matters of health, dress, conduct, safety, and well-being while on this trip. I have read the Conduct and Dress Code and understand that my child may be sent home at my expense if the Code is not followed. I agree to reimburse NiCE Foundation for any additional expenses that they incur as a result of my child not following the previously mentioned code.   

 

X______________________________________________________

     signature of parent or guardian                                              date