Workshop Permission Form

Workshop Permission Form
Child's Name

First NameLast Name
Age
Date of Birth

MonthDayYear
Date
Gender
Parent/Legal Guardian Name

First NameLast Name
Relationship to the Minor
Phone Number 1
Format: (000) 000-0000.
Phone Number 2
Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does the child have any allergies?
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
Date Signed

MonthDayYear
Date
Should be Empty: