Mexico 2007
For King and Kingdom
Davidson Academy

Registration Form

Name _______________________________________________________________     Sex:  M  or  F 

Grade ________     Email address ____________________________________________________

Home Phone __________________________     Cell Phone __________________________

I (We) the undersigned parents(s) or guardian(s), do hereby grant permission for

_________________________________________ (student) to participate in the Mexico Mission Trip on

February 16-23, 2007. We understand that all reasonable precautions will be taken by Davidson Academy

personnel to ensure the safety of the students involved in this activity.  We agree to abide by the rules and

regulations of the school as set forth in, but not limited to, the online Handbook.

Insurance Company _________________________________    Policy or Group No. _______________

Insured's Name _____________________________________________________________________

Parent/Guardian's Contact Numbers:

Home ____________________    Office _____________________    Mobile ____________________

___________________________________________________________
Signature(s) of Parent(s)/Guardian(s)                                   

__________________________________
Date