Permission Form

 

                    Child's Name_______________________________________________________________

                    Address___________________________________________________________________

                    City_________________________________State______________Zip_________________

                    Home Phone_______________________________________________________________

                                                                                                                                        

                    My child,____________________________________has my permission to send this information

                    (picture, poem, story) to be shared on the Web Site.

                    Signature of Parent___________________________________________________________


Contact Us: In the Desert Children's Project    425 10th Street Moline, IL 61265 (520) 405-1634  info@inthedesertchildrensproject.org
          OUR HOME PAGE :  www.InTheDesertChildrensProject.org