LDS Permission PDF Details

Both the participant and parent or guardian (if necessary) are required to sign and date the form. The form is intended to ensure the safety and well-being of participants and inform event planners and leaders of any special considerations or medical information they need to be aware of during the event.

You will find info about the type of form you need to complete in the table. It can tell you the time you will need to fill out lds permission form, exactly what parts you will need to fill in and some other specific facts.

Form NameLDS Permission Form
Form Length1 pages
Fillable fields34
Avg. time to fill out7 min 7 sec
Other nameslds activity permission form, permission slip, lds permission forms, lds consent form

Form Preview Example



Permission and Medical Release Form









Complete this form separately for each event or activity involving special considerations (see Handbook 2: Administering the Church, 13.6.20,, an overnight stay, travel outside the local area, or an activity with higher than ordinary risks.

Event Details (to be filled out by event planner)














Date(s) of event












Describe event and activities (please be specific)




































Event or activity leader


Event or activity leader’s phone number

Event or activity leader’s email

























Date of birth














Primary telephone number



Secondary telephone number






 Cell  Work




 Cell  Work








State or province










Emergency contact (parent or guardian)

Primary telephone number


Secondary telephone number







 Cell  Work



 Cell  Work











Does the participant require a special diet?


If yes, please explain the dietary restrictions





 Yes  No









Does the participant have any allergies?


If yes, please list the allergies





 Yes  No









Is the participant taking any medication or over-the-counter (OTC) drugs?

If yes, can the participant self-administer his or her medication?


 Yes  No




 Yes  No If no, please contact the event or activity leader directly.


List all prescription or over-the-counter (OTC) medications the participant is taking




















Does the participant have a chronic or recurring illness?


If yes, please explain





 Yes  No









Has the participant had surgery or a serious illness in the past year?

If yes, please explain





 Yes  No









Identify any other limits, restrictions, or disabilities that could prevent the participant from fully participating in the event or activity (attach additional pages if needed)


Other Accommodations or Special Needs

Identify any other needs or considerations the participant has that the event or activity planner should be aware of (attach additional pages if needed)


I give permission for my child or youth to participate in the event and activities listed above (unless noted) and authorize the adult leaders supervising this event to administer emergency treatment to the abovenamed participant for any accident or illness and to act in my stead in approving necessary medical care. This authorization shall cover this event and travel to and from this event.

The participant is responsible for his or her own conduct and is aware of and agrees to abide by Church standards, camp or event safety rules, and other pertinent instructions. Participants’ conduct and interactions should abide by Church standards and exemplify Christlike behavior. Parents and participants should understand that participation in an activity is not a right but a privilege that can be revoked if they behave inappropriately or if they pose a risk to themselves or others.

Participant’s signature

Parent or guardian’s signature (if necessary)



© 2017, 2019 by Intellectual Reserve, Inc. All rights reserved. 5/19. PD60004035 000

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completing lds permission slip half sheet step 1

You have to fill out the Does the participant require a, If yes can the participant, Physical Conditions That Limit, Does the participant have a, If yes please explain, If yes please explain, Other Accommodations or Special, Identify any other needs or, Permission I give permission for, The participant is responsible for, Participants signature, and Date box with the required particulars.

step 2 to completing lds permission slip half sheet

Determine the crucial details in the Parent or guardians signature if, Date, and by Intellectual Reserve Inc All part.

Entering details in lds permission slip half sheet stage 3

Step 3: Choose the Done button to save your form. So now it is at your disposal for transfer to your gadget.

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