J12 Campout

J-12 Campout Permission Slip Event: J-12 Campout (4th–6th Grade Overnight) Location: New Life Chapel, [10184 7th AVE Hesperia Ca 92345] Dates: Friday, October 17th, 2025 – Saturday, October 18th, 2025 Drop-off: Friday at 5:00 PM Pick-up: Saturday at 11:00 AM.

Student Name *Enter your full name.

Grade

4th Grade

5th Grade

6th Grade

Parent/Guardian Name: *Enter your full name.

Phone Number(s):

Emergency Contact Name & Number: *

Allergies or medical conditions we should be aware of:

Parent/Guardian Consent & Release I, the undersigned parent/legal guardian of the above-named student, give permission for my child to participate in the J-12 Campout hosted by New Life Chapel. I understand that reasonable precautions will be taken to ensure my child’s safety. I agree to release and hold harmless New Life Chapel, its staff, volunteers, and representatives from any liability, claims, demands, and causes of action whatsoever which may arise from or in connection with my child’s participation in this event. In case of an emergency, I authorize the event leaders to secure medical treatment for my child, including hospitalization, anesthesia, surgery, or medications as deemed necessary by qualified medical personnel.

Parent/Guardian Signature

Date Select the date.

J12 Campout

Contact

Office Hours

Address