Mission Project Name

Dates X – Y, 200Z

Permission to Participate Form for High School Students

Please return this form and a deposit for $250.00(*) no later than ______________ to your Parish coordinator. Checks should be made payable to your Church.

I/We give our daughter/son permission to join the collaborative _____________ team, being co-sponsored by our parish, _____________________.

This permission form confirms that the leaders of the _______________ team can proceed with purchasing an airline ticket and making all other arrangements for our child to attend.

Participants Name: ______________________________________________

Participants Passport Name: ______________________________________________

Signature of Participant: __________________________________________

Parent(s) Name(s): _____________________________________________________________

Signature of Parent(s): ___________________________________________________________

Date Signed: __________________

Primary Mailing Address for Parent/Participant:

Street: _______________________________ City: _________________

(H) Phone: ______________________ Zip Code: __________

(W or Cell) Phone: ___________________