Night Out with the Family
Please complete this form if your child is lodging with Hudson Lab Ventures and you or a trusted family friend would like to take your child out for dinner or an outing during non-program hours.
Name of Person Completing This Form
First Name
Last Name
Email of Person Completing This Form
example@example.com
Your Child's Name
First Name
Last Name
HLV Program your child is attending
Lisbon #1: June 16-27
Lisbon #2: June 30 - July 11
Porto: July 14-25
NYC: July 14-25
Seoul: July 28 - Aug 8
Date of Outing
-
Month
-
Day
Year
Date
Time of Outing
Hour Minutes
AM
PM
AM/PM Option
RETURN Time of Outing
Hour Minutes
AM
PM
AM/PM Option
Please provide additional information here if necessary.
Trusted Adult Taking Your Child Out for Dinner/Outing if not you
If a trusted family friend is taking your child out for dinner or an outing during non-program hours, please provide their information here.
Name of Trusted Adult
First Name
Last Name
Phone Number of Trusted Adult
Please enter a valid phone number.
Format: (000) 000-0000.
Email of Trusted Adult
example@example.com
Consent & Acknowledgement
*
By submitting this form, I confirm that I am the parent or legal guardian of the student named above. I am requesting that my child be permitted to leave the Hudson Lab Ventures program temporarily for a meal or outing with either myself or the trusted adult I have identified in this form. I acknowledge and consent that during this time, either I (the parent/guardian) or the named adult will assume full responsibility for my child’s supervision, safety, and conduct. I understand that Hudson Lab Ventures staff will release my child to this adult and will not be responsible for my child during this period. I agree to provide accurate contact information and to coordinate clear pickup and drop-off details with the program team.
Submit
Should be Empty: