Connecting with Nature
Consent Forms
Participate or Student Name
First Name
Last Name
Phone Number
Grade/Age
School Name
Guardian/Supervisor name
First Name
Last Name
Description of Community Service Activity
Name of the Organization
Please list food allgeries and or medical conditions.
Please provide an emergency contact number and name
Permission
I, undersigned, agree with the following statement
I, parent/guardian of the above-named student/participate, gave my permission for my son/daughter to participate in Connecting with Nature community activites described above.
I, partcipate/guardian agrees for Connecting with Nature non-profit to take photos and videos during events.
I, partcipate of Connecting with Nature hereby to agree for photos and videos to be published to social media and website.
I, the parent/guardian of the above-named student, certify that my son/daughter is allowed to be monitored by Connecting with Nature staff and volunteers.
I, participate of Connecting with Nature understands that we are not responsible or liable for any injures and or accidents that occur during our events.
Parent/Guardian Name
First Name
Last Name
Signature
Today's Date
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