Tyler Area Christian Home Educators

 

Member Consent Form

 

 

 

_____________________________ has my permission to be responsible for my child(ren)

 

 

___________________, ___________________, ___________________,

 

 

___________________, ___________________, ___________________

 

at this TACHE event.

 

In case of medical emergency they are authorized to seek medical attention for my child(ren).

 

 

 

 

Parent signature  / Date  /  Phone number

 

 

 

 

Heath Insurance Information:

 

Company:  _________________________________

 

Policy:  # __________________________________

 

Doctor:  ____________________________________

 

Preferred Hospital:  ____________________________