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Please send this Release Form to Attn Youth Department 606 Greenville Ave Staunton VA 24401 Phone 540-886-0771 Fax 540-886-5734 Email youth pcsda.org. Youth Olympics 2017 EMERGENCY TREATMENT/LIABILITY RELEASE PARENTAL PERMISSION FORM Potomac Conference Adventist Youth Ministries Shenandoah Valley Academy THIS FORM MUST BE COMPLETED AND SIGNED BY A PARENT OR GUARDIAN FOR CHILDREN AND TEENS UNDER 18 YEARS OF AGE. Contact person in case of emergency NAME ADDRESS Street City State Zip Code EMAIL...
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