WAIVER AND RELEASE OF LIABILITY

WAIVER AND RELEASE OF LIABILITY

Parental Authorization Form For Minors
Minor's Name:

First Name Last Name
Date of Birth:

Month Day Year
Date
Legal Guardian Name:

First Name Last Name
Copy of the ID Card of the Legal Guardian:

Cancel of
Copy of the minors insurance card:

Cancel of
I am the legal guardian of the minor named above, having full and complete custody, do hereby authorize name of minor to volunteer & attend Monolith on the Mesa from September 14th - 19th 2022.
Date

Month Day Year
Date
Guardian's Signature

Clear
Should be Empty: