Parental / Guardian Consent Form

Parental / Guardian Consent Form

FOR MINORS BETWEEN THE AGE OF 11 to 14 YEARS
Parent/Guardian: Please read and complete this parental consent form in full.
Name of Minor*

First NameLast Name
Date of Birth*

YearMonthDay
Date
In case of emergency, Tsukino-Con may reach me at*
Please enter a valid phone number.
Permanent Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Daytime Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Evening Phone Number
Please enter a valid phone number.
Email*
example@example.com
A minor (child) for whom I am the parent or legal guardian, has my permission to attend the convention Tsukino-Con during the month of February, 2026.

I understand that my child is responsible for his/her own behaviour at all times and if my child participates in any behaviour that presents a danger to himself/herself and / or others, appropriate steps will be taken to ensure the safety of my child and all individuals attending the convention, and I may be liable for the damage caused. In the event of an injury, the convention staff may also act on my behalf in obtaining immediate emergency medical treatment for my child.

I hereby forever release Tsukino-Con, its staff, and volunteers from any and all liability out of or in any way related to Tsukino-Con and not arising directly from the gross negligence of Tsukino-Con staff and volunteers.
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Signature*

Clear
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