Minor Policy Form

Minor Policy Form

Parent must fill this form out if the student is under 18 years old
Childs Name*

First NameLast Name
Childs Name (2)

First NameLast Name
Childs Name (3)

First NameLast Name
Childs age
Childs Age (2)
Childs Age (3)
Parents Name*

First NameLast Name
Phone Number*
Does your child have any food or medication allergies?*
Does your child have any medical conditions that we should be aware of?
- For babysitting please make sure your child has a drink, snacks and lunch.
- In respect to other individuals taking the class; disruptive behavior will not be tolerated. If this occurs the guardian will be notified immediately.
- By this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child may be exposed to or infected by COVID-19 by participation; and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at Angelmedic CPR may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Angelmedic CPR, employees, program participants and their families.
- In the event of a serious medical emergency or serious injury, Angelmedic CPR staff will call Emergency Medical Services.
- We ask if the student has had recent flu like symptoms to contact us to reschedule in order to keep everyone safe.
- The following actions will not be tolerated:
  
  Disruptive behavior of any kind.
  Discourtesy to fellow students or staff.
  Disregarding the instructions of the program coordinator, instructors or other staff members.
  Making indecent or sexual remarks or gestures to anyone.
  Going ANYWHERE outside our training site ALONE without an instructor.
  Creating or contributing to unsanitary conditions.
  Destruction of property or equipment.
  Students should use their cellphones in between classes unless directed by instructor.
  Use of profanity.
- We ask an authorized adult to drop off and pick up the minor directly from the classroom.
We thank you for your understanding.
Do you require your child to wear a mask during class?*

YesNo
Other adults authorized to pick up your child

First NameLast Name
You agree to the above. Parent/ Guardian Signature*

Clear
Date*

MonthDayYear
Date
Additional comments below
Angelmedic CPR Training Center

801 W. State Road 436, STE 2183

Altamonte Springs, Fl 32714

tele: 321-347-2675
Should be Empty:

Minor Policy Form

Angelmedic CPR Training Center