DIOCESE OF SAN BERNARDINO YOUTH MINISTRY ACTIVITY PARENT CONSENT FORM Parish: St. Margaret Mary & Our Lady of Lourdes We the parents/guardians of _____________________________________________________ Request that our son/daughter be allowed to participate in the following youth ministry activity:
Date of Activity: Adult Coordinator: Judy Simon Destination: Time of Departure: Estimated Time of Return: " Reasons for Activity: # $ # % !& Means of Transportation: ' Cost per Youth: ( ) * & * ! & + ( Youth Needs to Bring: * * ./ ! !
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Please return forms to either church or hand it to Judy Simon by June 22, 2006 St. Margaret Mary Church Amplify Christ Youth Group 12686 Central Avenue Chino, CA 91710 Parents’ Signature: Date: Daytime phone: Cell phone: Participant’s cell phone number:
Our Lady of Lourdes Amplify Christ Youth Group 10191 Central Avenue Montclair, CA 91763