LIT Nursing Home Trip

The LIT students will be traveling to Creekside Assisted Living on Wednesday, December 7, 2022 to sing carols and share puppets with the residents. If your student(s) plan to attend, fill out the permission form below. Students will be riding in church vans driving by LIT leaders. The vans will depart at 6:00pm and will return by 7:00pm for parent/guardian pickup. If your student(s) does not plan to attend, they will remain at the church with LIT leaders for the evening. All permission forms must be receive NO LATER than Tuesday, December 6th.

LIT Nursing Home Permission Slip

Student Information

How many students do you have participating in the nursing home trip?(Required)

1 Student

2 Students

3 Students

Student Name 1(Required)

First Last

Student Name 2(Required)

First Last

Student Name 3(Required)

First Last

Emergency Contact Information

Parent/Guardian Name(Required)

First Last

Parent/Guardian Cell Phone(Required)

Parent/Guardian Email(Required)

Trip Consent

I give my permission for my student(s) to go with First Baptist Church of Ponca City to Creekside Assisted Living on December 7, 2022. I understand that they will ride in a church van driven by an LIT leader. The vans will depart at 6:00pm and will return by 7:00pm for pickup.

Consent(Required)

I give my consent.

By checking this box, you are giving consent for the student(s) listed above to attend the LIT Nursing Home trip.