Off Campus Event Permission Slip

Parent/Guardian Basic Information

Parent/Guardian Name(Required)
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Youth Basic Information

Youth Name(Required)
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Please enter a number from 10 to 17.
Youth Address(Required)

Emergency Contact


Medical Information

Physician's Name

Important Info

Open Arms Address: 2015 S 13th Street, Fort Pierce, FL 34950 Departure Time: 7:45 AM Return Time: 6:30 PM **Staff and Chaperones should park in spaces next to shed.**

Things to Bring

1. Water Bottle 2. Lunch (If Not Buying at Zoo) 3. Sunblock 4. Spending Money (Gift Shop, Snacks, Lunch, Etc.) 5. Neck Pillow for Travel (Optional)


1. All youth must sign this form indicating their agreement to these rules. 2. No one is allowed to attend without a signed parental permission slip and contact numbers. 3. No insults or sarcasm: We do not put others down, make fun of others, pick on others, or gossip about others. 4. Use your body respectfully: No revealing clothing, no PDA, no chasing, throwing, or hurting others. 6. Keep it clean: no swearing 7. NO personal video games. 8. Special medication or required items should be indicated on the permission form and given to the chaperones. 9. All participants must respect othersʼ physical boundaries. 13. Be considerate and respectful of other participants and leaders.
Click here to indicate that you and your youth have read the rules.(Required)
Medical and Liability Release(Required)
My Child Needs Financial Assistance
Trinity Lutheran Church believes that no child should be excluded for financial reasons and is happy to offer support when necessary. If your child needs assistance for this trip, please click the button above.
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