NXT Steps Initiative

NXT Steps Initiative Permission Slip

Parental Sign Up/Permission Slip
Event Name: NXT Steps Boys 1st Meeting (Session 1)
Event Date: January 16, 2025
Event Time: 2:00 PM - 3:00 PM
Child's Name*

First NameLast Name
Age*
Date of Birth*

MonthDayYear
Date
Parent/Legal Guardian Name*

First NameLast Name
Relationship to the Minor*
Phone Number 1*
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does the child have any medical conditions that you would like to declare?*
I, {parentlegalGuardian}, the parent or legal guardian of {childsName}, give my permission to join or participate in the Event stated in this form.
Parent's Signature*

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Date Signed*

MonthDayYear
Date
Should be Empty:

NXT Steps Initiative Permission Slip