NXT Steps Initiative Permission Slip

NXT Steps Initiative Permission Slip

Permission Slip
Event Name: NXT Steps Event
Event Date: TBD Saturday March 2026
Event Time: TBD
Young Man's Name*

First NameLast Name
Age*
Date of Birth*

MonthDayYear
Date
Parent/Legal Guardian Name*

First NameLast Name
Relationship to the Minor*
Parent/Guardian Phone*
Parent/Guardian Email*
example@example.com
Parent/Guardian 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.
Signature*

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Date Signed*

MonthDayYear
Date
Should be Empty: