Authorization Form .pdf

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Original filename: Authorization Form.pdf
Title: I xxxxx , authorize the association Notre Dame de Chrétienté to take
Author: VBI

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PARENTAL AUTHORISATION FOR MINOR CHILDREN (UNDER 18)

Name of child (children) :
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

I, the undersigned Mr/Mrs__________________________________________, hereby
-

Authorize the association “Notre-Dame de Chrétienté” to make all necessary
arrangements for any surgical intervention or urgent hospitalisation for my child
(children) above mentioned.

-

In my absence, place all responsibility for my child (children) above mentioned, in
the care of Mr/Mrs* _____________________________ participating adult on the
pilgrimage.

I can be contacted during the 3 days of the pilgrimage :
chapter : _______________________________________________________
phone (home and/or cell) : _________________________________________

Date : __________________________
Signature of the father or the mother (exclusively): _____________________________

*Delete as necessary

PLEASE ENSURE THAT THIS AUTHORISATION IS COMPLETED AND RETURNED

______________________________________________________________


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