2025 J-Van Permission Form

I, as a Parent/Guardian, give permission for my child(ren) to attend J-Van activities taking place within my complex between: July 14th – Aug 8th, 2025. I am aware that J-Van is a drop-in program and my child(ren) is/are free to participate for as short or long as they like and are free to return home to a parent/guardian during the program's activities. Please inform us if your child has a birthday during the dates of the program so that we can celebrate your child. If you have questions, please email us at: jvan@ywamnanaimo.com

Today's Date

Guardian's full name

Phone

Child's full name

Dropdown

Unit Number

In case primary parent/guardian can't be reached:

Phone

Does your child have allergies/medical conditions?

Yes

If yes, which allergies/medical conditions does your child have?

At J-Van, we love capturing joyful moments from our activities! From time to time, we may take photos of the children to share the fun on our social media or in updates to our sponsors. We respect you child's privacy- real names will never be used.

I give permission to J-Van to use photos that include my child(ren):

I agree

I disagree

Signature

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