Workshop Permission Form

Workshop Permission Form
Child's Name

First NameLast Name
Age
Date of Birth

MonthDayYear
Date
Gender

MaleFemale
Parent/Legal Guardian Name

First NameLast Name
Relationship to the Minor
Phone Number 1
Phone Number 2
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does the child have any allergies?

YesNo
Does the child have any medical conditions that you would like to declare?
Any special instructions?
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: