TRAVEL WAIVER

            For White's Ferry Road Church of Christ

I ____________________________________understand that immunizations are my responsibility.

                              (Printed Name)

I will be traveling with the WFR group to ___________________________on ______________.

                                                                            (Location)                                         (Date)

______________________________________________

(Signed Name or Guardian, if guardian then print name first)

Make sure that a copy of this is on file in Accounting.