Parent Certification for Volunteer Minors

Parent Certification

Student Volunteers Working with Minors
I, Enter Name the parent of Enter Name know of no reason
why Enter Name should not be allowed to work directly or indirectly with other minors. I also state that I know of no record of any incident that would be on file with the Department and text.
Parents Printed Name
Parents Signature
Email
example@example.com
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
What ministry are you volunteering for?
Should be Empty: